两种不同的通气模式对腹腔镜胆囊切除术老年患者通气功能的影响

The Impact of Two Different Ventilation Modes on Laparoscopic Cholecystectomy in Elderly Patients Ventilatory Function

目的探讨和研究两种不同的通气模式对腹腔镜胆囊切除术老年患者通气功能的影响。方法摘取我院近年来收治的腹腔镜胆囊切除术老年患者74例临床资料作为研究对象,随机将之分为观察组和对照组各37例,两组患者的分钟通气量均为100mL/kg,呼吸频率均为16次/min,其中观察组调整为压力控制模式;对照组则采用容量控制模式,对两组患者的通气功能情况进行统计对比。结果观察组和对照组在气腹后20min的PaCO2较气腹前均出现降低,差异具有统计学意义(P<0.05),两组对比则无明显差异,不具有统计学意义(P>0.05);观察组和对照组在气腹后20min的气道峰值较气腹前均出现增高,差异具有统计学意义(P<0.05),而且观察组明显低于对照组,差异具有统计学意义(P<0.05)。结论在分钟通气量及呼吸频率相同的情况下,两种模式均能保证患者的正常通气,而且压力控制模式比容量控制模式所维持的气道压力更低。

Objective To explore and study of two kinds of different ventilation modes on laparoscopic cholecystectomy in elderly patients with ventilation effect. Method For removal of treated in our hospital in elderly patients undergoing laparoscopic cholecystectomy 74 cases of clinical data as the research object, randomly divided into the observation group and the control group with 37 cases in each group, two groups of patients with minute ventilation are 100mL/kg, respiratory frequency are 16/min, the observation group for pressure adjustment control mode; control group using capacity control mode, two groups of patients with ventilation function for statistical comparison. The observation group and control group in the PaCO2 at 20rain after pneumoperitoneum were decreased, the difference was statistically significant （P〈0.05）, between the two groups showed no difference, do not have statistical significance （P〉0.05）; the observation group and the control group in the airway peak at 20min after pneumperitneum showed more increased, the difference was statistically significant （P〈0.05）, and the observation group was significantly lower than the control group, the difference was statistically significant （P〈0.05）. Conclusion In minute ventilation and respiratory frequency under the same circumstances, two kinds of mode can ensure that patients with normal ventilation, and the pressure control mode than the volume control to maintain airway pressure lower.