全麻联合硬膜外麻醉在老年单肺通气患者中的临床应用

Clinical applications of general anesthesia combined epidural anesthesia on unilateral lung ventilation of gerontal patient

目的:探讨全麻联合硬膜外麻醉在老年单肺通气患者中的临床应用价值。方法:选择31例老年患者实施全麻联合硬膜外麻醉,对麻醉后双肺通气、单肺通气5min、单肺通气45min和恢复双肺通气后患者通气指标(Paw、QS/QT和Vd/Vt)以及血气分析(PO2、PCO2和pH)进行比较。结果:实施单肺通气后Paw和QS/QT显著上升,且高于手术前和手术后双肺通气时(P<0.05),单肺通气5min时患者PO2出现降低,低于麻醉后的其他时间点(P<0.05),单肺通气5minPCO2升高,高于麻醉后的其他时间点(P<0.05)。结论:全麻联合硬膜外麻醉单肺通气,对患者肺内分流和动脉氧合影响较小,是一种安全的麻醉方式。

Objective： To investigate the value of anesthesia combined epidural anesthesia on unilateral lung ventilation of gerontal patient. Methods： 31 cases of gerontal patients were selected and taken anesthesia combined epidural anesthesia, blood gas analyzed （PO2, PCO2 and pH） and ventilation indicatrix （Paw, QS/QT and Vd/Vt） were contrasted at hibateral lung ventilation, 5 min and 30 rain unilateral lung ventilation and recuperation of hibateral lung ventilation. Results： Paw and QS/QT was higher after unibateral lung ventilation than at hibateral lung ventilation in postoperations and preoprations （P〈0.05）, level of PO2 begin ：increasing, and was higher than others time after anesthesia （P〈0.05）, level of PCO2 begin decreasing, and was lower than others time after anesthesia （P〈0.05）. Conclusion： Joint general anesthesia epidural anesthesia one- lung ventilation, the patients of pulmonary artery oxygenation divergence and less effect, it is a safe way of anesthesia.