胸腔镜食管癌根治术采用小潮气量快频率双肺通气联合右美托咪定效果观察

Thoracic mirror esophageal cancer cure using low tide gas volume fast frequency double lung ventilation combined right metometometo effect observation

目的观察胸腔镜食管癌根治术应用小潮气量快频率双肺通气联合右美托咪定的临床效果;方法选取本院收治的200例胸腔镜食管根治术患者,采用随机数字表法将患者分为单肺通气组(50例)、双肺通气组(50例)、右美托咪定组(50例)、联合组(50例),单肺通气组采用单肺通气,双肺通气组采用小潮气量双肺通气,右美托咪定组采用单肺通气联合右美托咪定,联合组采用小潮气量快频率双肺通气联合右美托咪定,比较四组患者麻醉诱导前(T0)、插管后即刻(T1)、胸腔镜操作开始即刻(T2)、操作结束后双肺间歇正压通气15min(T3)的气道平台压力、气道阻力、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)及术后肺不张及肺部感染情况;结果T1、T2、T3时间点,联合组患者的气道平台压力、气道阻力均显著低于其它3组(P<0.05);T1、T2、T3时间点,联合组患者的TNF-α、IL-6均显著低于其它3组(P<0.05);结论胸腔镜食管癌根治术患者采用小潮气量快频率双肺通气联合右美托咪定能够有效降低气道平台压力、缓解气道阻力,减少机体应激水平,降低肺不张及肺部感染风险,更有助于患者早期康复。

Objective To observe the clinical effect of small-tide gas volume fast frequency double lung ventilation combined with right metametomedin for the application of small-tide gas volume.Methods Select the 200 patients admitted to the hospital with thoracic mirror esophageal root treatment,Patients were divided into single-lung ventilation group(50 cases),double lung ventilation group(50 cases),right metameset group(50 cases),combined group(50 cases),Single lung ventilation group using single lung ventilation,double lung ventilation group using small tide gas volume double lung ventilation,right metomi set group using single lung ventilation combined right metomy,joint group using small tide gas volume fast frequency double lung ventilation joint right metomy,Comparing four groups of patients with pre-anaesthetic induction(T0),immediate post-intubation(T1),chest mirror operation immediately(T2),after operation,bipulmonary intermittent positive pressure ventilation 15 min(T3)of airway platform pressure,airway resistance,tumor necrosis factor-alpha(TNF-alpha),leukin 6(IL-6),Postoperative atelectasis and pulmonary infection;Results T1,T2,T3 time point,the joint group of patients′airway platform pressure,airway resistance are significantly lower than the other 3 groups(P<0.05);T1,T2,T3 time point,combined group patients TNF-alpha,IL-6 were significantly lower than the other 3 groups(P<0.05);Conclusion Chest mirror esophageal cancer treatment patients using small tide gas volume fast frequency double lung ventilation combined right meimi can effectively reduce airway platform pressure,relieve airway resistance,reduce body stress level,Reduce the risk of atelectasis and pulmonary infection,more conducive to early recovery of patients.