异丙酚和异氟醚对单肺通气肺内分流影响的比较

Comparason between the Effects of Propofol and Isofurane on Intrapulmonary Shunt during One Lung Ventilation

目的探讨及比较异丙酚和异氟醚对单肺通气（OLV）时缺氧性血管收缩（HPV）、肺内分流（Qs／Qt）的影响。方法24例病人随机分为两组：异丙酚麻醉组（Ⅰ组），异氟醚麻醉组（Ⅱ组）。Ⅰ组用微泵持续泵注异丙酚50μg·kg－1·min-1，Ⅱ组持续吸入异氟醚1％－2％。观察两组OLV不同时期Qs／Qt、PaO2、PvO2、PaCO2和pH值的变化。结果两组OLV时Qs／Qt明显升高，PaO2明显下降（P＜0．01）。但Ⅰ组的Qs／Qt组间时值变化在20％-25％之间，且组间无明显变化（P＞0．05）；Ⅱ组Qs／Qt的组内及组间的不同时值比较差异均有显著性（P＜0.05）。结论异丙酚不抑制OLV时的HPV，对Qs／Qt无明显影响；异氟醚在OLV时抑制HPV，且使Qs／Qt明显升高。

Pan Linghui Huang Bing, Wang Jianli, et al)(Department of Anesthesiology the Affiliated Turnor Hosptial,Guangxi Medical University ,Nanning (530021)[Abstract]Objective To study and comparatively evaluate the effects of propofol and isoflurane on hypoxic monary vasoconsiriction(HPV) and intrapulmonary shunt (Qs/Qt) during one lung vetilation (OLV). Method The twenty four patients were randomly divided into propofol (group Ⅰ) and isofiurane (groupⅡ) grouch. The anesthesia was maintained with an infusion of propofol(50μg·kg-1 ·min-1 in group Ⅰor with inhalation of isoflurane (1%～20%) ingroup Ⅱ. The arterial and mixedvenous blood were taken for blood gas analysis. The Qs/Qt was calculate. Results Qs/Qt incested, PaQ2 decreased significantly during OLV compared with that during TLV in two groups (P < 0.01 ). The difference between groups in Qs/Qt and in PaO2 was significant at all sampling points .Conchusion Propofol does neither ininhibit HPV nor influence on Qs/Qt during OLV. isoflurane either inhibits HPV or influences on Qs/Qt during OLV.[