论文部分内容阅读
目的麻醉诱导前吸入硫酸沙丁胺醇气雾剂(万托林),观察其对单肺通气早期呼吸力学的影响。方法合并慢性肺阻塞疾患(COPD)拟行肺叶切除手术的患者40例,随机分成观察组和对照组各20例,观察组:患者给予万托林200μg(2揿)后面罩吸氧;对照组:单纯面罩吸氧,30 min后开始麻醉诱导。记录监测时点的血气分析以及气道峰压、气道平台压、气道阻力、胸肺顺应性的变化。结果麻醉诱导前、双肺通气、单肺通气10 min及20 min的PaCO2观察组低于对照组,PaO2观察组高于对照组,P<0.05或P<0.01。双肺通气、单肺通气10 min及20 min的气道峰压、气道平台压、气道阻力观察组低于对照组,胸肺顺应性观察组高于对照组,P<0.05。结论硫酸沙丁胺醇气雾剂能降低COPD患者单肺通气早期的气道压力和气道阻力,增加胸肺顺应性,有利于术中呼吸管理,提高了麻醉手术的安全性。
Objective To inhale the salbutamol sulfate aerosol (wantroplin) before induction of anesthesia and observe its influence on early respiratory mechanics of single lung ventilation. Methods Forty patients with chronic obstructive pulmonary disease (COPD) undergoing lobectomy were randomly divided into observation group (20 cases) and control group (20 cases). In the observation group, patients were given vetorol 200μg (2 揿) : A simple mask oxygen, 30 min after induction of anesthesia. Blood gas analysis was recorded at the point of monitoring as well as changes in peak airway pressure, airway pressure, airway resistance, and lung-lung compliance. Results Before induction of anesthesia, PaCO2 in both lung ventilation and one lung ventilation group for 10 min and 20 min was lower than that of the control group, PaO2 observation group was higher than that of the control group, P <0.05 or P <0.01. Airway pressure, airway pressure and airway resistance in observation group were lower than those in control group in both lung ventilation, single lung ventilation for 10 min and 20 min, and those in lung compliance group were higher than those in control group (P <0.05). Conclusion Salbutamol sulfate aerosol can reduce the airway pressure and airway resistance in patients with COPD at the early stage of single lung ventilation and increase the compliance of the lung and lung, which is beneficial to intraoperative respiratory management and improve the safety of anesthesia.