Coopdech支气管封堵器对肺隔离通气病人血气及血清SP-D、VEGF的影响

Effect of Coopdech endobronchial blocker tube on serum of SP-D,VEGF and blood gas in selective lobar blockade patients with ventilation

目的评价Coopdech支气管封堵器在选择性肺叶隔离通气时对病人血气、血清SP-D和VEGF浓度的影响。方法选择VATS右肺中叶或下叶部分切除术病人80例,随机分为两组(n=40),双腔支气管导管组(V组):使用双腔支气管导管行单肺通气(OLV);Coopdech支气管封堵器组(C组):使用单腔气管导管配合Coopdech支气管封堵器,行左肺和右肺上叶通气。比较两组血气指标、血清肺表面活性蛋白-D(SP-D)和血管内皮细胞生长因子(VEGF)的浓度。结果与V组比较,C组病人T_1、T_2时氧合指数升高,气道峰压及气道平台压下降(P<0.05)。与V组比较,C组病人T_3时血清SP-D浓度下降(P<0.05)。血清VEGF浓度在组间与组内比较均无统计学差异(P>0.05)。结论 Coopdech支气管封堵器在选择性肺叶隔离通气时可以精确合理控制肺叶隔离;改善氧合、降低气道压、降低血清SP-D的浓度;可能具有肺保护效应,值得临床推广。

Objective To evaluate the effect of Coopdech endobronchial blocker tube on serum of SP-D, VEGF and blood gas concentration in the selective lobar blockade patients with ventilation. Methods 80 patients undergoing right-sided lung resection VATS were randomly divided into the double lumen endobronchial tube group （ group V） and the Coopdech endobronchial blocker tube group （ group C） . The group V was given double lumen en-dobronchial tube for one lung ventilation （ OLV ） , and the group C was given single lumen endotracheal tube and Coopdech endobronchial blocker tube for the left lung and right upper lobe of lung ventilation. Blood samples were taken from central vein for determination of serum SP-D, VEGF and blood gas. Results Compared with the group V, the value of PaO2 at T1 and T2 increased more obviously in the group C （P〈0. 05）. Compared with the group V, SP-D at T3 decreased in the group C （ P〈0. 05 ） . Serum VEGF concentration showed no significant difference be-tween the two groups （P〉0. 05）. Conclusion Coopdech endobronchial blocker tube can improve ventilation effi-ciency, lung protective effect and oxygenation and reduce the airway pressure, which is worthy of widely clinical pro-motion.