不同机械通气模式对腹腔镜术后患者循环及并发症的影响

Effects of different mechanical ventilation modes on circulation and complications in patients after laparoscopic surgery

目的探讨不同机械通气模式对腹腔镜术后复苏患者循环、并发症的影响。方法选取2017年5月-2018年2月于我院行全麻腹腔镜手术的患者共91例,均行机械通气,随机分为3组,分别采用容量控制通气(VC)模式、压力调节容量控制通气(PRVC)模式和同步间歇指令通气+吸气压力支持通气(SIMV+PSV)模式,观察在ICU时与脱机时的心率(HR)变化量、平均动脉压(MAP)变化量、血乳酸(Lac)变化量,脱机时呛咳呕吐反应等并发症情况。结果 3组HR变化量、MAP变化量比较差异无统计学意义(P>0.05);3组Lac变化量比较差异有统计学意义(P<0.05);SIMV+PSV组并发症发生率明显低于VC组,差异有统计学意义(P<0.05)。结论三种模式进行机械通气对患者呼吸循环功能无明显影响,但VC模式的并发症发生率高。

Objective To investigate the effects of different mechanical ventilation modes on circulation and complications of patients undergoing laparoscopic resuscitation.Methods Ninety-one patients underwent general anesthesia laparoscopic surgery at the Affiliated Tumor Hospital of Guangxi Medical University from May to February2018,2017. The mechanical ventilation of patients after surgery was randomized to VC(capacity controlled ventilation)mode and PRVC(pressure regulation capacity control). Ventilation mode and SIMV+PSV(synchronous intermittent command ventilation + inspiratory pressure support ventilation)mode,observe heart rate(HR)change,mean arterial pressure(MAP)change,and blood lactate during ICU and offline(Lac Complications such as changes,cough and vomiting reactions when offline.Results There was no significant difference in the changes of HR and MAP between the three groups(P>0.05). The changes of Lac in the three groups were statistically significant(P<0.05). The incidence of complications in the SIMV+PSV group was significantly lower. In the VC group,the difference was statistically significant(P<0.05).Conclusion Mechanical ventilation in the three groups has no significant effect on the respiratory function of patients,but the incidence of complications in VC mode is high.