| 白利群 兰元丹 张兵 张雨 田苗苗.保护性机械通气对开腹手术后肺功能的影响[J].,2015,15(27):5257-5259 |
| 保护性机械通气对开腹手术后肺功能的影响 |
| Effects of Protective Mechanical Ventilation on PulmonaryFunction after Open Abdominal Surgery |
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| DOI： |
| 中文关键词: 保护性通气 肺功能 肺感染 肺不张 |
| 英文关键词: Protective mechanical ventilation Pulmonary function Atelectasis Pulmonary infection |
| 基金项目:国家自然科学基金项目（81372026） |
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| 中文摘要: |
| 目的：探讨开腹手术期间使用保护性通气策略对于术后肺功能的恢复和肺感染的影响。方法：选择ASAⅠ~Ⅱ级择期行腹部
手术的患者50 例，预计手术时间大于2 h，体重指数<25%。将患者随机分为2 组：A组接受标准通气，潮气量8 mL/kg；B组接受
保护性通气，潮气量为6 mL/kg，10 cmH2O PEEP 以及肺复张。术后第1、3 天进行肺功能实验，检测PaO2和SPO2。术前和术后第
3 天进行胸部X 线和肺部感染评分。结果：与A 组患者比较，B 组患者术后第1、3 天的动脉氧合升高，且肺功能提高(P<0.05)；术
后第3 天肺不张的发生率降低(P<0.05)；术后第1、3 天肺感染评分显著降低(P<0.05)。结论：大于2 h的腹部手术中，使用保护性通
气可促进术后肺功能的恢复和减少肺感染的发生。 |
| 英文摘要: |
| Objective:To investigate the effect of protective mechanical ventilation during open abdominal surgery on postoperative
pulmonary and Pulmonary Infection.Methods:Fifty ASAⅠ orⅡ patients aged 40-65 yr BMI <25% scheduled for open abdominal
surgery lasting more than 2 h were randomly divided into 2 groups (n=12): standard ventilation group (group A) was assigned by envelopes
to mechanical ventilation with tidal volume of8 mL/kg. Protective ventilation (group B) was assigned by envelopes to mechanical
ventilation with tidal volume of 6 mL/kg, 10 cm H2O positive end-expiratory pressure, and recruitment maneuvers (protective ventilation
strategy). PaO2, SPO2 and pulmonary functional tests were measured preoperatively, as well as on day 1and 3 after surgery. Modified
Clinical Pulmonary Infection Score and Chest x-ray were measured on day 0 and 3.Results:Compared with group A, Patients of group B
showed better pulmonary functional tests up to day 3, fewer atelectasis to day 3 and higher arterial oxygenation in air on day 1, 3. The
modified clinical pulmonary infection score was lower in the protective ventilation strategy on day 3.Conclusion:A protective ventilation
strategy during abdominal surgery lasting more than 2 h improved respiratory function and reduced the modified Clinical Pulmonary Infection. |
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