摘要目的 观察小潮气量联合低水平呼气末正压(PEEP)对俯卧位手术患者氧合的影响.方法 对50例ASA Ⅰ或Ⅱ级,择期在全麻下行胸腰椎手术患者,随机均分为两组,研究组A组使用保护性肺通气模式,VT=6 ml/kg,PEEP=5 cm H2O.对照组B组使用常规机械通气模式,VT=10 ml/kg,分别监测麻醉前(T1)、俯卧位0.5 h后(T2)、拔管后0.5 h(T3)时的动脉血氧分压(PaO2)和术中的气道峰压(Ppeak)的变化,并计算氧合指数[PaO2/吸入氧浓度(FiO2)]的值.结果 与B组比较,A组在T3时的PaO2、PaO2/FiO2显著提高(P＜0.05).结论 保护性肺通气模式有助于改善俯卧位手术患者术后氧合.

abstractsObjective To investigate the effects of lower-tidal volume and low level of PEEP in patients undergoing prone position surgery on oxygenation. Methods Fifty patients, ASA Ⅰ or Ⅱ , undergoing spina surgery. Patients were randomly assigned to two groups, the study group(group A)was ventilated with]ung-protectire ventilation strategy (VT = 6 ml/kg, PEEP = 5 cm H2O). The control group (group B)was ventilated with conventional strategy(VT = 10 ml/kg). The effect of different time [Before anesthesiology (T1) , After 0. 5 hour in the prone position (T2), After tracheal extubation (T3)] on partial pressure of oxygen in artery (PaO2)and Peak airway pressure (Ppeak)were observed. PaO2/inhaled oxygen concentration (FiO2) was calculated. Results Compared with group B, PaO2, PaO2/FiO2 at T3 in group A was increased significantly(P ＜ 0.05). Conclusion Lung-protective ventilation strategy can improve pulmonary gas exchange in patients in the prone position.