国际麻醉学与复苏杂志   2016, Issue (2): 3-3
    
单肺通气期间麻醉期用药对肺内分流的影响
纪凡层, 牟爱珍1()
1.山东省潍坊市人民医院
Effects of drugs during anesthesia with one lung ventilation on pulmonary shunt fraction
 全文:
摘要：

背景　低氧血症是单肺通气（one lung ventilation， OLV）期间最常见的并发症。缺氧性肺血管收缩（hypoxic pulmonary vasoconstriction， HPV）是肺血管对局部低氧分压的反射性收缩，可以减少肺内分流（pulmonary shunt fraction， Qs/Qt）、维持动脉血氧分压（partial pressure of arterial oxygen， PaO2）、防止低氧血症的发生。　目的　探讨OLV期间麻醉期用药对Qs/Qt的影响，指导临床应用。　内容　综述OLV期间麻醉期用药对机体HPV、Qs/Qt和PaO2的影响。　趋向　OLV期间麻醉期用药可以对HPV产生抑制或增强作用，从而影响Qs/Qt和PaO2。临床上要避免使用抑制HPV作用、增加Qs/Qt的药物，防止患者出现低氧血症。
关键词： 单肺通气；　药物；　缺氧性肺血管收缩；　肺内分流
Abstract:

Background　Hypoxemia is one of the most common complications during one lung ventilation(OLV). Hypoxemia pulmonary vasoconstriction(HPV) is a reflex contraction of vascular smooth muscle in the pulmonary circulation in response to low regional partial pressure of oxygen. It can decrease pulmonary shunt fraction (Qs/Qt) and improve oxygenation.　Objective　To discuss the effects of drugs during anesthesia with OLV on Qs/Qt.　Content　Many drugs during anesthesia have an effect on HPV, Qs/Qt and oxygenation.　Trend　Drugs during anesthesia with OLV can inhibit or enhance the response of HPV, increase or decrease the Qs/Qt. We should avoid of drugs that inhibit the response of HPV and increase Qs/Qt. It can help patients to avoid of hypoxia.
Key words: One lung ventilation；　Drugs；　Hypoxic pulmonary vasoconstriction；　Pulmonary shunt fraction