国际麻醉学与复苏杂志   2010, Issue (3): 215-217
    
术侧肺部分通气法与单肺通气的比较研究
白浪 李桂凤 陈佳瑶 赵宇鹏 王清秀 姜桢1()
1.200120,上海市同济大学附属东方医院麻醉科(白浪、李桂凤、陈佳瑶、赵宇鹏、王清秀、姜桢)
Comparison of partial ventilation of independent lung with one-lung ventilation
 全文:
摘要：

目的 与单肺通气 （one-lung ventilation，OLV） 比较术侧肺部分通气 （partial ventilation of independent lung，PLV）情况下的氧合与气道压力。 方法 16例接受食道手术的患者随机分为两组， 进行自身对照交叉研究。在双肺通气后按不同顺序接受 OLV 和术侧肺 PLV， 比较3种通气时氧合指数 （oxygen index ，OI） 及气道压力的变化。 结果 两种通气方式下 OI均显著低于双肺通气 （two-lung ventilation， TLV） ， 但PLV时显著高于OLV （PLV391±112， OLV134±53， TLV530±92， ） ； 气道压力值在PLV时也显著低于 OLV［Ppeak： （19±3）cm H2O vs （27±5）cm H2O ，Pplat： （17±2）cm H2O vs （23±3）cm H2O ，P<0.05 ］ （1 cm H2O =0.098 kPa） 。 结论 PLV显著改善了氧合和呼吸力学指标。
关键词： 开胸术；单肺通气；部分通气，术侧肺
Abstract:

Objective The purpose of this study was to compare oxygenation and airway pressure during partial ventilation of the independent lung(PLV) with one-lung ventilation(OLV). Methods 16 patients undergoing thoracotomy for esophageal carcinoma were randomized divided into two groups and a self-controlled cross-over study was used. Two types of ventilation was used in different sequence after two-lung ventilation(TLV), oxygenation index(OI) and airway pressure was compared between groups. Results OI was significantly lower during OLV and PLV than TLV, while it was significantly higher during PLV than OLV（PLV391±112，OLV134±53，TLV530±92，P<0.05）.Airway pressure was also significantly lower during PLV than OLV [Ppeak:(19±3)cm H2O vs (27±5)cm H2O, Pplat:(17±2)cm H2O vs (23±3)cm H2O, P<0.05].Conclusion PLV significantly improve oxygenation and respiratory mechanics.
Key words: Thoracotomy; One-lung ventilation;Partial ventilation, independent lung