基于压力-容积曲线的个体化肺保护性通气在接受腹腔镜卵巢囊肿剥除术肥胖患者中的应用

Application of individualized lung protective ventilation based onpressure-volume curve in obese patients undergoing laparoscopicovarian cystectomy

目的探讨基于压力-容积曲线的个体化肺保护性通气在接受腹腔镜卵巢囊肿剥除术肥胖患者中的应用效果。方法选择2022年2月至2023年5月定州市人民医院收治的60例接受腹腔镜卵巢囊肿剥除术的肥胖患者为研究对象,按照随机数字表法分为两组,各30例。对照组实施容量控制模式机械通气,观察组采取基于压力-容积曲线的个体化肺保护性通气,比较两组动脉血氧分压、动脉血二氧化碳分压(PaCO2)水平及麻醉机呼吸参数和并发症发生情况。结果机控15 min、机控1 h及手术结束时两组的动脉血氧分压水平高于麻醉前,观察组高于对照组(P<0.05);观察组PaCO2、气道峰值压、气道平台压和平均气道压低于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论腹腔镜卵巢囊肿剥除术肥胖患者采取个体化的压力-容积曲线肺保护性通气,可有效改善机体氧合状态,维持内环境稳定,降低气道压及呼吸相关并发症的发生率。

Objective To explore the application effect of individualized lung protective ventilation based on pressure-volume curve in obese patients undergoing laparoscopic ovarian cystectomy.Methods A total of 60 obese patients who underwent laparoscopic ovarian cystectomy in Dingzhou People’s Hospital from February 2022 to May 2023 were selected as the research objects.According to the random number table method,they were divided into two groups,with 30 cases in each group.The control group was given volume control mode of mechanical ventilation,and the observation group was given individualized lung protective ventilation based on pressure-volume curve.The levels of arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide(PaCO2),anesthesia machine respiratory parameters and complications were compared between the two groups.Results The levels of arterial partial pressure of oxygen at 15 min,1 h of machine control and the end of operation in both groups were higher than those before anesthesia,and those in the observation group were higher than those in the control group(P<0.05).PaCO2,peak airway pressure,plateau airway pressure and mean airway pressure in the observation group were lower than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion The application of individualized pressure-volume curve lung protective ventilation in obese patients undergoing laparoscopic ovarian cystectomy can effectively improve the oxygenation status of the body,maintain the stability of the internal environment,and reduce the airway pressure and the incidence of respiratory complications.