自制低压给氧装置在胸科手术中的应用及效果评价

【摘要】 目的 评价自制低压给氧装置在胸科手术中的临床应用及效果。方法 择期胸科手术患者60例，性别不限，年龄18～75岁，ASA分级Ⅰ～Ⅱ级。采用随机数字表法分为2组（n=30）：单肺通气后术侧管空置（A组）；单肺通气后低压给氧装置用于术侧肺吹氧（B组）。观察麻醉诱导前（T1），双肺通气平卧位（T2），开胸后单肺通气15 min（T3），单肺通气30 min（T4），单肺通气45 min（T5），术毕双肺通气平卧位（T6），术后6 h（T7）时记录动脉血气PaO₂值。采用Campos肺萎陷分级法进行术中肺萎陷程度评价。结果 T1-4时点，两组PaO₂比较差异无统计学意义（P>0.05）；单肺通气时T5时点，B组PaO₂高于A组，差异有统计学意义（P<0.05）；双肺通气时两组患者T2时PaO₂高于T6,T6时B组PaO₂高于A组，差异有统计学意义（P<0.05）;T7时点B组PaO₂高于A组，差异有统计学意义（P<0.05）；两组患者均顺利完成手术，手术医师对肺萎陷满意，差异无统计学意义（P>0.05）。结论 自制低压给氧装置可用于胸科手术单肺通气时术侧肺吹氧，安全有效且不影响手术操作。更多还原

【Abstract】 Objective To evaluate the clinical application and effect of self-made low pressure oxygen supply device in thoracic surgery.Methods Sixty ASAⅠorⅡpatients of both sexes aged 18 to 75 years undergoing elective thoracic surgery with ASA grade Ⅰ～Ⅱwere divided into 2 groups（n=30 each）using a random number table:the non-ventilatory side tube was empty after one-lung ventilation（OLV）（Group A）;low pressure oxygen supply device after OLV was used for oxygen blowing on the operative side（Group B）. Before induction of anesthesia（T1）,at the supine position with TLV before operation（T2）,at 15 min of OLV after thoracotomy（T3）,at 30 min of OLV（T4）,at 45 min of OLV（T5）,at the supine position with TLV after operation（T6）,and at 6hours after operation（T7）,the arterial blood gas PaO₂ were recorded. The degree of intraoperative lung collapse was evaluated by Campos classification. Results At time T1～4,there was no significant difference in PaO₂ between the two groups（P>0.05）. At T5 of one-lung ventilation,PaO₂ in group B was higher than that in group A（P<0.05）;At T2,PaO₂ was higher than T6,and at T6,and PaO₂ was higher than A in group B（P<0.05）. PaO₂ in group B was higher than that in group A at T7（P<0.05）. Both groups of patients successfully completed the operation,the surgeon was satisfied with the lung collapse（P>0.05）. Conclusion The self-made low pressure oxygen supply device can be used to ventilate the lungs on the operative side during one lung ventilation in thoracic surgery,which is safe,effective and does not affect the operation.更多还原