容量切换与压力切换两种呼吸切换模式在妇科腹腔镜手术全身麻醉中应用的观察对比

Clinical Outcome Comparison of Volume Controlled Ventilation and Pressure Controlled Ventilation during General Anesthesia for Gynecological Laparoscopic Operations

目的观察妇科腹腔镜手术全身麻醉期间容量切换与压力切换两种呼吸管理模式对术中循环和呼吸功能的影响。方法将60例行妇科腹腔镜手术患者随机分为L组和P组，L组全麻呼吸管理采用容量切换模式，P组全麻呼吸管理采用压力切换模式，观察术中气腹和体位改变后患者呼吸、循环、血气分析及球结膜的变化情况。结果L组气腹后肺顺应性降低，气道峰压、气道阻力、PETC02较气腹和体位改变前增加（P〈0．05）。血压、心率升高（P〈0．05）。P组气腹后肺顺应性降低、气道阻力增加（P〈0．05）。气道峰压、PETC02无明显改变。血压、心率基本稳定，与L组同时间点比较差异有统计学意义。L组较P组球结膜水肿发生率高（P〈0．05）。结论在妇科腹腔镜手术全身麻醉中压力切换模式呼吸管理较容量切换模式有一定优越性。

Objective To identify and compare the impact on intra-operative circulation and respiration of comparison of volume controlled ventilation （ VCV ） and pressure eontrallod ventilation （PCV） during general anesthesia for gynecological laparoseopie operations. Methods Sixty patients who underwent gynecological laparoseopie surgeries were randomly dividld into Group L and Group P. Group L undertook volume eontralled ventilation mode in respiratory management, while pressure controlled ventilation mode for Group P. Intro-operative respiratory, circulation, artery blood gas and change of bulbar eonjunetiva after introduetion of pneumoperitaneum and change of body position were recorded and analyzed. Results The compliance of lungs, peak pressure, resistance, PET CO2, blood pressure and heart rate after introduction of pneumoperitoneum and change of body position in Group L was significantly increased （ P 〈 0.05 ）, whilst compliance of lungs was lower in Group P. The resistance was higher （ P 〈 0.05 ） ; peak pressure and PET CO2, were not ehanged in Group P. And blood pressure and heart rate were steady. There was a higher incidence in Group L in terms of bulbar eonjunetiva edema （ P 〈 O. 05 ）. Conclusion PCV was superior than VCV during general anesthesia for gynecological laparoseopie operations.