摘要
目的:比较全身麻醉过程中正压通气对老年患者呼气末和动脉血CO2差值的影响,以间接评估对肺功能的影响.方法:20例行骨科和腹部外科择期手术患者,随机分为两组,机械通气方法如下:组1吸入氧浓度(F1O2)=100%,机械控制通气(CMV):潮气量(VT)=6～8ml/kg,频率(f)=10～14次/min,吸呼比为1:2;组2F1O2=100%,CMV:VT=6～8ml/kg,f=10～14次/min,呼气末正压通气(PEEP)=5 emH2O,吸呼比为1:2.所有患者机械通气后维持呼吸末二氧化碳分压(PETCO2)在25～40mmHg之间.持续行收缩期血压(SBB)、舒张期血压(DBP)、心率(HR)及PETCO2监测,记录动脉血氧分压(PaO2)和动脉二氧化碳分压(PaCO2)值;同时计算PaCO2与PETCO2的差值.结果:机械通气后5 min、1 h和2h两组患者PaO2下降,PaCO2-PETCO2差值升高,但组2这种变化的幅度较小.结论:当PEEP为5 cmH2O时,可明显改善全身麻醉CMV时的PaO2与PaCO2-PETCO2差值.
Objective ： To investigate the effects of general anesthesia and ventilation on PaCO2 - PET CO2 in elder patients. Methods： Twenty patients undergoing selective abdominal or orthopaedics surgeries were divided into two groups randomly. The ventilation styles were as follows： Group 1：F1O2 = 100%, CMV：VT=6-8ml/kg,f=10-14/min,I ： E = 1 ： 2 ; Group2： F1O2=100%,CMV：VT= 6-8ml/kg,f= 10 - 14/min,PEEP =5 cmH2O,I ： E = 1 ： 2. The hemodynamics （SBP, DBP and HR） were monitored. We also detected PaO2, PaCO2 and PETCO2 5 min, 1 h or 2 h after ventilation. Results： There was no significant difference in SBP, DBP or HR between the two groups. PaO2 increased in both of the two groups and PaCO2 - PETCO2 increased in group 1 after general anesthesia and ventilation. The changes in Group 2 were all different from those of Group 1 （P 〈 0. 05 ）. Conclusion ： A low level of PEEP, which is about 5 cmH2O may improve PaO2 and PaCO2 - PETCO2 after general anesthesia and ventilation in elder patients.
出处
《医学研究生学报》
CAS
2005年第9期818-820,共3页
Journal of Medical Postgraduates
关键词
机械控制通气
老年患者
二氧化碳
Positive pressure ventilation
Elder patients
End tidal CO2
