| 马晓彤,陈燕琪,宋雨童,等.压力控制容量保证通气模式在腹腔镜袖状胃切除术中的应用[J].安徽医药,2022,26(11):2270-2274. |
| 压力控制容量保证通气模式在腹腔镜袖状胃切除术中的应用 |
| Application of pressure-controlled volume-guaranteed ventilation mode in laparoscopic sleeve gastrectomy |
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| DOI：10.3969/j.issn.1009-6469.2022.11.034 |
| 中文关键词: 呼吸，人工 正压呼吸 压力控制容量保证通气 病态肥胖 腹腔镜袖状胃切除术 呼吸力学 气体交换 |
| 英文关键词: Respiration,artificial Positive-pressure respiration Pressure-controlled ventilation with volume-guaranteed Mor. bid obesity Laparoscopic sleeve gastrectomy Respiratory mechanics Gas exchange |
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| 目的探究在腹腔镜袖状胃切除术中，应用压力控制容量保证通气(PCV-VG)模式对病态肥胖病人呼吸力学及气体交换功能的影响。方法选取 2020年 5―12月徐州医科大学附属医院腹腔镜袖状胃切除术病人 80例，分为压力控制容量保证组( P组)和容量控制组( V组)。记录插管后 5 min(T1)、建立气腹后 30 min(T2)、 60 min(T3)、撤气腹后 5 min(T4)的气道峰压(Ppeak)、气道平均压( Pmean)、肺动态顺应性( Cdyn)、潮气量( TV)、动脉氧分压( PaO2)、动脉二氧化碳分压( PaCO2)，动脉氧饱和度(SaO2)并计算氧合指数( OI)、动脉 -呼气末二氧化碳分压差( Pa-ETCO2)、肺泡 -动脉血氧分压差( Pa-AO2)、死腔率( VD/ VT)，术后 3d肺部并发症发生率。结果排除剔除病例后， 72例病人纳入最终分析，每组 36例。在 T1T2T3、T4时点， P组的 Ppeak［( 20.69± |
| 英文摘要: |
| Objective To investigate the effects of pressure-controlled volume-guaranteed ventilation (PCV-VG) on respiratory me. chanics and gas exchange function in morbidly obese patients during laparoscopic sleeve gastrectomy.Methods A total of 80 patientswho underwent laparoscopic sleeve gastrectomy in the Affiliated Hospital of Xuzhou Medical University from May to December 2020were selected and divided into the PCV-VG group (group P) and the volume-controlled ventilation (VCV) group (group V). The peak air. way pressure (Ppeak), mean airway pressure (Pmean), pulmonary dynamic compliance (Cdyn), tidal volume (TV), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial oxygen saturation (SaO2), calculated oxygenation index (OI), arterial-end-tidal carbon dioxide partial pressure difference (Pa-ETCO2), alveolar-arterial oxygen partial pressure difference (Pa-AO2), dead space rate (VD/VT) were recorded 5 minutes after intubation (T1), 30 minutes (T2), 60 minutes (T3), and 5 minutes after the pneu. moperitoneum was withdrawn (T4). The incidence of pulmonary complications at 3 days after the operation was recorded.Results After exclusion, 72 patients were included in the final analysis, with 36 cases in each group. At T1, T2, T3, and T4, the Ppeak [(20.69±3.61)mmHg, (23.72±3.64) mmHg, (24.11±3.89) mmHg, (21.08±3.48) mmHg] in group P was lower than that in group V [(22.33±3.18)mmHg, (28.17±3.03) mmHg, (28.78±2.67) mmHg, (22.56±2.51) mmHg] (P<0.05). Compared with group V, group P had higher Pmean and Cdyn at T2 and T3 (P<0.05); higher PaO2 and OI at T4; and lower Pa-AO2 (P<0.05); Pa-ETCO2, PaCO2 and VD/VT were lower in at T2~T4 and T3~T4, respectively (P<0.05); and the incidence of SaO2, TV and postoperative pulmonary complications were comparable be. tween the two groups (P > 0.05).Conclusion Compared with the volume controlled ventilation (VCV) mode, the PCV-VG mode can re. duce peak airway pressure, improve lung compliance, and improve oxygenation function while providing stable tidal volume for morbidpatients. |
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