文章摘要
甘亚倩 肖向峰 陈刚 郭晓东.呼气末正压通气对骨肿瘤患者呼吸功能及血流动力学的影响[J].,2015,15(3):487-489
呼气末正压通气对骨肿瘤患者呼吸功能及血流动力学的影响
Effect of PEEP on Pulmonary Function and Hemodynamic Indexes ofPatients with Bone Tumors Operation
  
DOI:
中文关键词: 骨肿瘤  呼气末正压  呼吸功能  血流动力学
英文关键词: Bone tumor  Positive end-expiratory pressure  Respiratory function  Hemodynamic indexes
基金项目:国家自然科学基金青年科学基金项目(30901795)
作者单位
甘亚倩 肖向峰 陈刚 郭晓东 武汉市黄陂区人民医院麻醉科解放军第302 医院北 
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中文摘要:
      目的:探讨呼气末正压通气(Positive end expiratory pressure,PEEP)对全麻状态下行骨肿瘤手术的患者血流动力学的影响。方 法:选取2013 年1 月至2014 年1 月在我院接受手术治疗的骨肿瘤患者30 例,随机分成对照组(PEEP 0 cm H2O,n=15)和研究组 (PEEP 8 cmH2O,n=15)。所有患者行常规麻醉诱导后机械通气。观察并比较两组患者不同时间点的气道峰压(Ppeak)、气道平台压 (Ppla)、PaO2和PaCO2等呼吸功能指标,以及心率(HR)、平均动脉压(MAP)和中心静脉压(CVP)等血流动力学指标的变化。结 果:两组组内比较,PaO2值下降(P <0.05);研究组Ppeak 和Ppla 显著增加(P<0.01),对照组无显著差异(P>0.05)。与对照组相比 较,研究组患者相同时间点的PaO2值、Ppeak 及Ppla 明显增加,差异具有统计学意义(P <0.05)。两组组内比较,HR、MAP 及CVP 值的差异均无统计学意义(P>0.05);与对照组相比较,研究组患者相同时间点的CVP 值上升,HR 和MAP 值下降,但差异无统 计学意义(P>0.05)。结论:PEEP通气对全麻下骨肿瘤手术患者的呼吸功能具有改善作用,且加用PEEP 对患者血流动力学参数 的影响不明显,可在临床推广应用。
英文摘要:
      Objective:To study the effect of positive end-expiratory pressure (PEEP) on the respiratory function and hemodynamic indexes for patients with bone tumor surgery.Methods:30 patients with bone tumors surgery under general anesthesia with ASA class Ⅰ or Ⅱ from January 2013 to January 2014 were enrolled and randomly divided into the control group (PEEP 0 cm H2O, n=15) and the study group (PEEP 8 cm H2O, n=15). All patients were given mechanical ventilation after general anesthesia induction and PEEP. Then the respiratory function, including the Ppeak, Ppla, PaO2 and PaCO2, and the hemodynamic indexes such as the heart rate, MAP and CVP of patients at different time points were recorded and compared between the two groups.Results:Within the two groups, PaO2 value decreased(P<0.05); Ppeak and Ppla in study group increased significantly(P<0.01); there was no statistically significant difference about Ppeak and Ppla in the control group (P>0.05). Compared with that of the control group, PaO2 value, Ppeak and Ppla of the study group increased (P<0.05). There was no statistically significant difference about the HR, MAP and CVP within each group (P>0.05). The CVP increased, and the HR and MAP decreased in the study group, but there was no statistically significant difference (P>0.05).Conclusion:The application of PEEP in bone tumor patients under general anesthesia during the operation can improve the respiratory function of patients as well as the less effects on hemodynamic parameters.
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