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单肺麻醉时的氧合问题

OXYGENATION DURING ONE-LUNG VENTILATION IN OPEN CHEST SURGERY

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【作者】 张京范孟燕谢荣

【Author】 Zhang Jingfan, et al.Anesthesia Department, First Teaching Hospital Beijing Medical University

【机构】 北京医科大学第一医院麻醉科北京医科大学第一医院麻醉科

【摘要】 本文目的在于寻找一通气方式,预防单肺麻醉下发生低氧血症。23例开胸手术的患者,麻醉诱导后插入Carlens双腔管,行双肺机械通气,于开胸后10min取动脉血测血气后,即改为单肺通气(下肺),而上肺的Carlens管则开放至空气(对照组)或连接KR-Ⅱ型高频呼吸机行高频通气(频率120bpm、送气压力1-1.5kg·f/cm2)。观察结果表明:单肺通气时,开胸一侧的肺采用高频通气;健侧肺仍维持常规的正压呼吸。这样,可显著改善动脉血液的氧合。

【Abstract】 One lung ventilation (OLV) is often used as a method to isolate the diseased from the normal lung and to improve operating condition.However, very large variable alveolar toarterial oxygen tension difference (PA-aDO2) and hypoxemia may occur during OLV. 23 patients intubated with a Carlens double-lumen endobronchial tube were observed during intrathoracic surgery. HFJV(120 breaths/min, driving pressure 1-1.5kg·f/cm2) was added to the noadepeudent lung while the dependent lung was being ventilated with IPPV. The results show that PaO2 can be improved during open chest surgery when the patient is ventilated in this manner.

  • 【文献出处】 临床麻醉学杂志 ,The Journal of Clinical Anesthesiology , 编辑部邮箱 ,1989年03期
  • 【被引频次】3
  • 【下载频次】27
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