异丙酚对单肺通气时肺内分流的影响

The Effect of Propofol on Intrapulmonary Shunt during One Lung Ventilation

目的：探讨异丙酚对单肺通气（ＯＬＶ）时缺氧性肺血管收缩（ＨＰＶ）、肺内分流（Ｑｓ／Ｑｔ）的影响。方法：观察组用异丙酚６～１２ｍｇ·ｋｇ－１·ｈ－１静注，对照组用不抑制ＨＰＶ、对Ｑｓ／Ｑｔ无影响的普鲁卡因４０～６０ｍｇ·ｋｇ－１·ｈ－１静滴。观察两组ＯＬＶ不同时期Ｑｓ／Ｑｔ、ＰａＯ２、ＰｖＯ２、ＰａＣＯ２和ｐＨ值变化。结果：ＯＬＶ时两组病人Ｑｓ／Ｑｔ明显升高，ＰａＯ２明显下降（Ｐ＜０．０１），ＰｖＯ２、ｐＨ、ＰａＣＯ２无明显变化。ＯＬＶ时，两组病人的Ｑｓ／Ｑｔ和ＰａＯ２组内不同时值或组间同时值比较均无显著差异（Ｐ＞０．０５）。结论：异丙酚不抑制ＯＬＶ时ＨＰＶ，对Ｑｓ／Ｑｔ无明显影响，ＯＬＶ时无低氧、高碳酸血症和酸碱失衡。

Objective: This study eveluates the effect of propofol on hypoxic pulmonary vasoconstriction (HPV) and intrapulmonary shunt(s/t) during one lung ventilation(OLV). Methods: 20 patients sheduled for thoracic operation were randomly divided into propofol (group Ⅰ) and control (group Ⅱ) groups. The anesthesia was maintained with an infusion of either propofol (6～12mg·kg-1·h-1) in group Ⅰ or procaine (40～60mg·kg-1·h-1) in group Ⅱ. The arterial and mixed venous blood were taken for blood gas analysis. The Qs/Qt was calculated. Results: s/t increased, PaO2 decreased significantly during OLV compared with that during TLV in two groups (P<001). The differences between two groups in s/t and PaO2 were insignificant at all sampling points. Conclusion: Propofol does not neither inhibit HPV nor influence on s/t during OLV.