单肺通气中自发呼气末正压和动脉氧分压的关系

Auto PEEP and PaO 2 in one lung ventilation

目的：探讨单肺通气中自发性呼气末正压（ａｕｔｏＰＥＥＰ）和氧分压（ＰａＯ２）之间可能存在的关系。方法：选择３０例开胸手术患者行单肺通气，用呼气末呼气口堵塞的方法测量ａｕｔｏＰＥＥＰ，术中均做血气分析。结果：单肺通气ａｕｔｏＰＥＥＰ显著高于双肺通气（Ｐ＜０．０１）；单肺通气中，ａｕｔｏＰＥＥＰ和术前ＦＥＶ１／ＦＶＣ呈负相关（Ｐ＜０．０１），和动脉ＰａＯ２无相关性（Ｐ＞０．０５）。结论：在单肺通气过程中，很多患者不需要将气体呼出到功能残气量的程度。

Objective:To investigate the possible relationship between auto positive end expiratory pressure(auto PEEP) and arterial oxygen tension(PaO 2) in one lung ventilation(OLV).Methods:30 patients scheduled for thoracic surgery received OLV anesthesia.Auto PEEP was measured with end expiratory port occlusion method and arterial blood gas analysis was measured in all patients during operation.Results:The mean value of auto PEEP was significant higher in OLV than in two lung ventilation(2 LV)( P <0.01).In OLV,auto PEEP was inversely correlated with preoperative forced expiratory volume/forced vital capacity( P <0.01),and had no correlation with PaO 2( P >0.05).Conclusions:These findings confirm that in OLV many patients do not exhale completely to functional residual capacity.