婴儿胸腔镜手术单肺通气过程中发生低脑氧合的危险因素

Risk factors of cerebral oxygen desaturation during one-lung ventilation in infants undergoing thoracoscopic surgery

目的分析婴儿胸腔镜手术单肺通气(OLV)过程中发生低脑氧合(COD)危险因素。方法55例择期行胸腔镜下肺囊腺瘤切除术患儿根据OLV时是否出现COD分为A组(30例,发生COD)和B组(25例,未发生COD),采用单因素分析法和多因素Logistic回归分析法分析婴儿胸腔镜手术中OLV发生COD的危险因素。结果单因素分析显示,低血压事件、呼气末二氧化碳分压和气道峰压(P_(peak))是婴儿胸腔镜手术中OLV发生COD的影响因素(P均<0.05);多因素Logistic回归分析显示,低血压和高P_(peak)是婴儿胸腔镜手术中OLV发生COD的危险因素(P均<0.05)。结论婴儿胸腔镜手术中OLV发生COD的危险因素是低血压和高P_(peak)。

Objective To analyze the risk factors of cerebral oxygen desaturation(COD)during one lung ventilation(OLV)in infants undergoing thoracoscopic surgery.Methods Fifty-five infants who underwent elective thoracoscopic cystadenoma resection were divided into group A(30 cases with COD)and group B(25 cases without COD)according to the occurrence of COD during OLV.The risk factors of COD in OLV were analyzed by univariate analysis and multivariate Logistic regression analysis.Results Univariate analysis showed that hypotension,end-expiratory partial pressure of carbon dioxide(P_(peak)CO_(2))and peak airway pressure(P_(peak))were related to COD during OLV in infants undergoing thoracoscopic surgery(all P<0.05).Multivariate Logistic regression analysis showed that hypotension and high P_(peak) were risk factors for COD during OLV in infants undergoing thoracoscopic surgery(both P<0.05).Conclusion The risk factors for COD during OLV in infants undergoing thoracoscopic surgery are hypotension and high P_(peak).