摘要
本实验组为５例食道癌剖胸手术患者，间歇正压高频振荡通气（ＨＦＯＶ）时间平均为２００±７７．２７３５ｍｉｎ（１００～２９０ｍｉｎ），在ＨＦＯＶ技术条件相对固定的情况下，用ＢＫ１３０４脉搏氧饱和度仪作术中动态观察，并定时抽取动脉血样进行ＢＧＡ对照。结果提示，１）在剖胸手术中使用间歇正压ＨＦＯＶ是可行的。术中ＢＧＡ结果ｐＨ值７．３６１３±０．０５９４、ＰａＣＯ２３７．３８７５±６．５９８８ｍｍＨｇ、ＰａＯ２１７３．２０６３±５５．９０９２ｍｍＨｇ、ＳａＯ２２９９．０６２５±０．８８０１％。２）指脉搏氧饱和度与动脉ＢＧＡＺ间有良好的相关性，ＰＥＣＯ２与ＰａＣＯ２，相关系数为０．７７８２。可作为动态观察的重要指标，以便及时调整ＨＦＯＶ各项技术参数。３）剖胸术中ＨＦＯＶ的ＤＧＰ按０．０３Ｋｇ／ｃｍ２／ｋｇ计算时，一次送气量（ＶＴ）是足够的，但需排除胸肺顺应性的个体差异。４）当前存在的问题仍然是对胸肺顺应性较差的患者如何使用ＨＦＯＶ？我们主张提高吸气相的气道压。
he intermittent.positive pressure high frequency oscillation ventilation(IPPHFOV)was used in 5 patientsundergoing thoracotomy for a period of 200±77.3 min,SpO2 and blood gas analysis(BGA)were monitored duringIPPHFOV.The results:(1)SpO2 and BGA value;were in normal limits.(2)SpO2 was well correlated withBGA. PETCO2 was well correlated with PaCO2(r=0.7782),which is a good indicator for selecting the best ventila-tion parameters.(3)VT was sufficient when DGP 0.03kg/cm2/kg was set in the patients with normal compliance.(4)The question is how to use HFOV in the patients with abnomal lung compliaince.It is suggested that airwaypressure during inspiration be increased when HF(iV is used for the patients with abnormal thoraco-lung compli-ance.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
1995年第4期203-205,共3页
Journal of Clinical Anesthesiology
