单肺通气时改变呼吸频率对潮气量和每分钟通气量的影响

The Effect of Respiratory Frequency Change on Tidal Volume and Minute Volume during One-lung Ventilation

本文观察17例肺叶切除术的病人,探讨了双肺通气(TLV)、单肺等容通气(OLV-等容)和单肺等压通气(OLV-等压)时不同呼吸频率(f)对潮气量(V_r)、每分钟通气量(V_E)及血气值的影响。结果显示:改变f对气道压力(Paw)无影响。f与VT呈负相关r=-0.09,而与V_E呈正相关r=0.99。OLV时 V_r较TLV 时明显减少,V_E 也相应减少;提高f可使OLV-等容时V_E 的不足得以缓解,而 OLV-等压则不然。OLV 时血气值也发生了改变,即 PaO_2 较TLV降低 50％,而 PaCO_2 在 OLV-等压时升高,通过调整V_A 可予纠正。

The purpose of this study was to observe the influence of respiratory fre qucncy (f) change on tidal volume (VΥ) .minute volume (VE) and blood-gas analysis during two-lung ventilation (TLV),and one-lung ventilation (OLV). 17 adult patients under going selected pulmonectomy were divided into 3 groups according to different respiratory modes;TLV,OLV with equal tidal volume and OLV with equal airway pressure (Paw). The results show that: 1)The change of f didn't affect Paw;2) f had a negative correlation with VΥ(TLV:Υ= - 0. 96;OLV:Υ= - 0. 99),and a positive correlation with VE(Υ = 0. 99) ;3) VΥ decreased more obviously during OLV than during TLV (P<0.01) ,and then VE reduced accordingly. In this case ,the insufficient part of VE can be compensated by increasing f ,but VΥ during OLV-equal Paw was reduced in order to preserve the consistent lower Paw as TLV;and 4) At the same time the related blood-gas analysis were abnormal. PaO2 was 50% lower during OLV than during TLV. PaCO2 was higher during OLV-equal Paw than during TLV (P<0. 01).