全身麻醉联合硬膜外麻醉在老年单肺通气的应用效果

Efficacy of combined general epidural anesthesia on elderly patients with single lung ventilation

目的探讨老年单肺通气患者应用全身麻醉联合硬膜外麻醉的临床效果。 方法选取2013年7月至2014年7月老年单肺通气患者30例，手术选用全身麻醉联合硬膜外麻醉，分析其不同时间点通气指标及血气分析指标。 结果单肺通气后，气道压力（Paw）、肺血分流率（QS/QT）高于双肺通气时，差异有统计学意义（P〈0.05）。单肺通气5 min，氧分压[PaO2，（183.20±23.20）mmHg，1 mmHg＝0.133 kPa]低于麻醉后其他时间点，而二氧化碳分压[PaCO2，（53.20±1.50）mmHg]高于麻醉后其他时间点，差异有统计学意义（P〈0.05）。 结论老年单肺通气应用全身麻醉联合硬膜外麻醉，可减少麻醉用药量，值得临床应用推广。

Objective To investigate the efficacy of combined general epidural anesthesia on elderly patients with single lung ventilation. Methods From July 2013 to July 2014, 30 elderly patients with single lung ventilation were selected, combined general epidural anesthesia was applied in surgery, and the index of lung ventilation and blood gas analysis at different points were analyzed. Results After the single lung ventilation, airway pressure （Paw）, and pulmonary blood flow rate （QS/QT） were higher than those at double lung ventilation time, the differences were significant （P 〈 0. 05 ）. One-lung ventila- tion in 5 min, oxygen pressure [ Pa02, （ 183.20±23.20） mmHg, 1 mmHg = 0. 133 kPa ] was lower than that of other time points after anesthesia, but partial pressure of carbon dioxide [ PaCO2, （53.20±1.50） mmHg] was higher than that of other time points after anesthesia, the differences were significant （P 〈 0. 05 ）. Conclusions Elderly single lung ventilation in patients with general anesthesia combined epi- dural anesthesia, may reduce the anaesthesia to use the dose, is worth applying the promotion.