大容量全肺灌洗术术中低氧血症35例临床分析

Hypoxemia in whole lung lavage: clinical analysis of 35 cases

目的讨论大容量全肺灌洗术(whole lung large WLL)术中低氧血症的临床原因。方法对35例WLL术中低氧血症患者和未发生低氧血症患者35例进行尘肺期别、体重、术前有无基础病、术前血气分析、术前肺功能、术中气道压、灌洗液残余量进行分析。结果 35例低氧血症患者,超重、术前肺功能异常、术前血气PO2<70 mm Hg、术中气道压高、灌洗液残余量大、支气管痉挛者明显高于对照组。结论 WLL术中低氧血症的发生与超重、术前肺功能异常、术前血气PaO2<70mm Hg、术中气道压高、灌洗液残余量大和支气管痉挛等因素有关。

[Objective] To explore the clinical reasons for hypoxemia in whole lung lavage(WLL).[Methods] Pneumoconiosis staging and analysis of weight,with preoperative underlying disease or not,preoperative blood gas,preoperative pulmonary function,intraoperative airway pressure,lavage residual were perforemed on 35 cases who received WLL with hypoxemia and 35 cases who received WLL without hypoxemia.[Results] The analysis showed the rates of overweight,preoperative pulmonary function abnormalities,intraoperative blood gas PO 2 <70 mm Hg,intraoperative airway high pressure,large volume of lavage residual,bronchospasm of the hypoxemia patients were significantly higher than those of the control group.[Conclusion] The hypoxemia in WLL is related with overweight,preoperative pulmonary function abnormalities,intraoperative blood gas PO2<70 mm Hg,intraoperative airway high pressure,large volume of lavage residual,bronchospasm.