全麻诱导期呼气末正压通气对腹腔镜下子宫肌瘤剔除术后患者呼吸功能的影响

Effect of positive end expiratory pressure on respiratory function in patients undergoing laparoscopic myomectomy after induction of general anesthesia

目的探讨全身麻醉诱导呼气期末正压通气对腹腔镜下行子宫肌瘤剔除术患者的呼吸功能的影响。方法选取2015年10月—2016年10月收治的的需行子宫肌瘤剔除术的210例患者,随机分为观察组和对照组各105例,两组均进行腹腔镜下子宫肌瘤剔除术,对照组在手术中使用呼气末正压通气,观察组采用全身麻醉诱导期便开始加用呼气末正压通气,比较两组围术期血流动力学参数、呼吸参数、动脉血气变化并计算呼吸系统顺应性,计量资料组间比较采用t检验,P<0.05为差异有统计学意义。结果对照组气腹30、60、90 min及放气时的呼气末二氧化碳的分压差值水平、肺顺应性均高于对照组同期水平、氧合指数低于对照组同时期氧合指数水平,差异均有统计学意义(均P<0.05)。结论全麻诱导呼气期末正压通气对腹腔镜下行子宫肌瘤剔除术具有良好的临床疗效,值得临床推广应用。

Objective To investigate the effect of total anesthesia induced positive end expiratory pressure on respiratory function in patients undergoing laparoseopic myomectomy. Methods 210 cases of patients who underwent myomectomy in our hospital from October 2015 to October 2016 were randomly divided into two groups, the observation group and the control group, each group of 105 patients were randomly divided into the treatment group and the control group （n=2）. Two groups of patients were performed laparoscopic myomectomy, the control group was used in the operation of positive end expiratory pressure ventilation, the observation group used general anesthesia induction period began to add positive end expiratory pressure ventilation. The hemodynamic parameters, respiratory parameters and arterial blood gas changes of two groups were observed and recorded. Results The patients in the control group in 30, 60, 90min pneumoperitoneum and deflation when Pa-ET CO2 level, lung compliance were significantly higher than those in the control group, the level of oxygenation index was significantly lower than the control group at the same time, oxygenation index level, the difference was statistically significant, P〈0.05. Conclusion The positive pressure ventilation induced by general anesthesia has a good clinical effect on laparoscopic myomectomy, and it is worthy of clinical application.