异丙酚对单肺通气时肺内分流的影响

The effects of propofol on intrapulmonary shunt during one lung ventilation

目的 :观察异丙酚对单肺通气 ( One- lung ventilation,OLV)时低氧性肺血管收缩 ( Hy-poxic pulmonary vasocontriction,HPV)和肺内分流 ( Qs/ Qt)的影响。方法 :选择 2 0例 ASA ～ 级开胸手术患者随机分为异丙酚组 ( 1)和对照组 ( ) ,每组 10例 ,麻醉诱导气管插管后 组用异丙酚 4 -12 mg/ kg· h静脉持续输注 : 组用普鱼卡因复合液维持麻醉。在麻醉后双肺通气 ( Two- lung ventilation,TL V) 15min( T1 )、OL V30 min( T2 )、OL V60 min( T3)恢复 TLV30 min( T4) 4个时间点分别抽取动脉血和右心房血 ,行血气分析检查 ,并计算肺内分流量 ( Qs/ Qt)。结果 :OLV后 T2 、T3与 T1 相比两组的 Qs/ Qt)有明显升高 ( P<0 .0 5) ,而 Pa O2 和 Sa O2 下降非常显著 ( P<0 .0 1) ;但两组同时间比值比较无明显差别 ( P>0 .0 5)。结论 :异丙酚对 HPV无明显抑制作用 ,OLV时 Qs/

Objective:To observe the effects of propofol on hypoxic pulmonary vasoconstriction(HPV) and intrapulmonary shunt during one lung ventilation(OLV).[WT5HZ]Methods:[WT5BZ]20 patients of ASA Ⅰ～Ⅱ undergong thoracic operation were randomly divided into two group with 10 patients in each group:propofol group(Ⅰ group)and control group(Ⅱ group).The anesthesia was maintained with infusion of 4～12 mg/kg·h propofol in group Ⅰ,and infusion 40～60mg/kg·h procaine in group Ⅱ.The arterial and right atrium bloods were taken for blood gas analysis at the following time:TLV 15 min(T 1)、OLV30min(T 2)、OLV60min(T 3)、TVL30min(T4),and the Qs/Qt was calculated.Result:]Qs/Qt increased(p<0.05),while PaO 2 and SaO 2 decreased significantly(p<0.01) at T 2 or T 3 compared with that at T 1.There were no significantly differences between the two groups at the same time points.Conclusion:Propofol did not inhibit HPV,and less increase intrapulmonary shunt during OLV.