摘要
目的：比较在老年肺癌患者行肺叶切除术单肺通气时，两种通气方法对动脉血气值及肺内分流的影响。方法：老年肺癌择期行肺叶切除术患者45例，年龄60～79岁，ASA Ⅰ—Ⅱ级，随机分为3组。A组：对照组；B组：单肺通气时术侧肺行高频喷射通气（HFJV）；C组：术侧肺行持续气道正压通气（CAPA）。分别于单肺通气前，单肺通气30min，单肺通气结束，恢复双肺通气30min。测动脉血测血气分析。根据公式计算肺内分流率。结果：单肺通气30min及单肺通气结束时，B、C两组PaO2较A组高，Qs／Qt较A组降低（P〈0．05）。但B、C两组间各时点数据比较差异无显著性。结论：老年肺癌患者行肺叶切除术单肺通气时，术侧肺实施CPAP及HFJV均可明显提高氧分压。减少肺内分流，有临床推广价值。
Objective： to investigate the effects of non - ventilated lungwith continuous positive airway pressure （CPAP） and High Frequency Jet Ventilation （HFJV） on blood gas and intrapulmonary shunt during one-lung ventilation in lung cancer open chest surgery of aged patients. Methods： Forty-five aged lung cancer patients（aged 60 - 79 years） undergoing selective thoracic operation, ASA Ⅰ-Ⅱ , were selected and randomly divided into three groups （each group with 15 patients）. Group A： controlled group, there were no ventilation on the non - ventilated lung open to the air; group B： CPAP was administered with O2 （P= 3cmtf20） via CPAP system on the non - ventilated lung during one lung ventilation; Group C： HFJV was administered with O2 （P=0.5-1.0Kg/cm^2）; Blood gas analysis were determined at 30 min after two - lung ventilation （TLV）, 30 min after one lung ventilation （OLV）, at the end of OLV and 30 min after the second times TLV, and Qs/Qt was calculated by formulation. Results： PaO2 in group B,C were increased significantly than that of in group A （P〈 0. 05） during OLV; Qs/Qt in group B,C were decreased significantly than that of in group A （P〈 0. 05）. But there was no significant difference of PaO2 and Qs/Qt between group B and C. Conclusion： CPAP and HFJV could imp rove the systemic oxygenation and reduce the intrapulmonary shunt, they are clinically significant during one-lung ventilation in lung cancer open chest surgery of aged patients.
