小剂量乌拉地尔对单肺通气期间动脉氧合及血流动力学的影响

Effect of low-dose urapidil on oxygenation and hemodynamics during one lung ventilation

目的观察小剂量乌拉地尔对单肺通气(OLV)期间动脉氧合及血流动力学的影响。方法择期行食管癌根治术患者100例,随机均分为两组,分别在OLV期间持续静脉输注乌拉地尔4μg·kg-1·min-1(U组)和等容量生理盐水(C组)。记录两组双肺通气20min(T0)、OLV20min(T1)、30min(T2)、45min(T3)、60min(T4)时的氧合指标及血流动力学指标。结果与T0时比较,T1～T4时两组患者PaO2均明显降低,Qs/Qt明显升高(P<0.01)。与T1时比较,T3、T4时U组患者PaO2显著升高,Qs/Qt显著降低(P<0.05);T4时C组患者PaO2明显升高,Qs/Qt明显降低(P<0.05)。与C组比较,T3、T4时U组患者PaO2明显升高,Qs/Qt明显降低(P<0.05)。两组各时点MAP、HR差异无统计学意义。结论小剂量乌拉地尔可改善OLV期间动脉氧合,减少肺内分流,但对血流动力学无明显影响。

Objective To observe the effect of low-dose urapidil on oxygenation and hemodynamics during one lung ventilation （OLV）. Methods One hundred patients scheduled for esophageal cancer radical operation were randomized into two groups with 50 each. Patients received intravenous infusion of urapidil 4μg. kg 1.min-1 （group U） and the same volume of saline （group C）, respectively during OLV. Oxygenation and hemodynamic parameters of the two groups were recorded 20min after two lung ventilation and 20, 30, 45, 60 min after OLV. Results Compared with group C, PaOz increased while pulmonary shunt fraction （Qs/Qt） decreased 45 and 60 min after OLV in group U（P〈0.05）. There was no significant difference on MAP and HR between the two groups. Conclusion Low-dose urapidil can reduce pulmonary shunt and ameliorate oxygenation status without significant influence on hemodynamics during OLV.