摘要
目的评价肺复张对深低温停循环主动脉术后低氧血症的治疗作用及安全性。方法前瞻性随机对照研究。2010年11月至2011年11月行深低温停循环主动脉手术术后发生低氧血症患者40例,随机分为两组:对照组(n=20),行常规机械通气治疗;试验组(n=20),行肺复张治疗。对比两组患者机械通气时间及肺复张前后呼吸和循环参数的变化。结果肺复张组患者氧合明显改善(PaO2/FiO2:94.0±2.9vs.180.4±31.8,P<0.001);肺复张期间对血管活性药物剂量进行调整后,患者的平均动脉压、心率、中心静脉压均可维持稳定状态;肺复张组较常规治疗组的机械通气时间缩短,但差异无统计学意义[(25.4±16.4)hvs.(21.8±12.6)h,P=0.493]。结论肺复张可改善深低温停循环主动脉术后的氧合状态,且患者耐受性良好,是一种安全有效的治疗手段。
Objective To investigate the clinical effect of lung recruitment maneuver on postoperative hypoxemia of deep hypothermia circulatory arrest （ DHCA ） aortic surgery. Methods From November 2010 to November 2011 , forty patients undergone DHCA aortic surgery with postoperative hypoxemia were randomly allocated into two groups ： control group （ n = 20 ） ： conventional mechanical ventilation; experimental group （ n = 20 ） ： lung recruitment maneuver（RM）. The arterial blood gas and haemodynamics variables were compared between the two groups. Results The oxygenation index of RM group was improved significantly（ PaO2/FiO2：94. 0 ± 2. 9 vs. 180. 4 ±31.8,P 〈 0. 001 ）, and in both groups the haemodynamics were stable. The mechanical ventilation time in RM group was shorter than control group [ （ 25.4± 16.4 ） h vs. （ 21.8 ± 12. 6 ） h, P = 0. 493 ]. Conclusions Lung recruitment maneuver is an effective and safe method to improve the oxygenation of hypoxemia patients after DHCA aortic surgery.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第8期71-74,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
停循环
深低温诱导
低氧
肺复张
Circulatory arrest, deep hypothermia induced
Hypoxemia
Recruitment maneuver
