低潮气量机械通气在全身麻醉中的应用

Application of low tidal volume ventilation in the surgery with general anesthesia

目的 探讨全身麻醉应用低潮气量（VT）机械通气的可行性.方法 回顾分析2005年1月至2013年3月在全身麻醉下行择期手术患者200例,按照机械通气VT不同分为两组,各100例.Ⅰ组VT 8～10 mL/kg,应用传统潮气量通气;Ⅱ组VT 6～〈8 mL/kg,应用小潮气量通气.比较术中两组患者呼气末二氧化碳（PETCO2）、气道压、血氧饱和度（SpO2）、胸肺顺应性等相关指标.结果 两组SpO2比较,差异无统计学意义（P＞0.05）;Ⅱ组术中PETCO2 高于Ⅰ组,差异有统计学意义（P＜0.05）;Ⅱ组术中气道平台压、气道峰压低于Ⅰ组,差异均有统计学意义（P＜0.05）,而两组胸肺顺应性比较,差异无统计学意义（P＞0.05）.结论 低VT机械通气作为一种肺保护通气策略应用于全身麻醉是可行的.

Objective To explore the feasibility of mechanical ventilation with low volume of tidal（VT） for the surgery with general anesthesia. Methods A total of 200 patients,who underwent selective surgery under general anesthesia from January 2005 to March 2013 ,were analyzed retrospectively and divided into two groups with 100 cases in each group according to the dif- ferent VT of mechanical ventilation. Patients with 8-10 ml_/kg VT in the group I were subject to traditional ventilation,while those with 6-〈8 mL/kg V~ in group ]1 adopted mechanical ventilation. The related indicators including end tidal CO2（PErCO2）, peak airway pressure, oxyhemoglobin saturation （SpO2）,lung-thorax compliance and so on in the two groups were continuously monitored and compared. Results The difference of SpOz in the two groups had no statistical significance （P〉0.05）. The content of PrrCO2 in the I group was higher than that in the I1 group with statistically significant difference（P〈0.05 ）. The Pplat and Ppeak in the 11 group were lower than those in the I group with statistically significant difference （P〈O.05）, but there was no statistically significant dif- ference between the two groups on the comparison of lung-thoras complicance （P〉O.05）. Conclusion The mechanical ventila- tion with low VT as a lung protective ventilation strategy is feasibility for the surgery with general anesthesia.