个性化滴定PEEP肺保护策略与术中氧合关系的研究

王 立梅¹, 徐 建军²
1、佳木斯大学
2、大庆油田总医院

摘要

目的：观察个性化PEEP与术中氧合的关系。方法：选取全麻气管插管手术共60例，预计手术时间大于2小时，性别不限，年龄大于18岁小于80岁，体重指数为18.5-32.5 kg/m2，ASA分级为Ⅰ-Ⅲ级。共60例患者随机分为对照组和实验组，对照组PEEP设置为5cm H2O，实验组PEEP根据患者机械通气时肺最大顺应性确定。观察指标：两组患者机械通气时肺的顺应性；两组患者于麻醉诱导前（T1）、手术1小时（T2）、手术缝合时（T3）进行动脉血气采集，记录氧合指数即IO：PaO2/FiO2。结果：两组患者机械通气时肺顺应性分别为实验组（54.00±16.13）ml/cmH2O、对照组（41.50±11.37）ml/cmH2O，实验组的肺顺应性显著高于对照组，差异有统计学意义（P＜0.05）；对照组手术1小时的氧合指数下降明显，有统计学意义（P＜0.05）；实验组中氧合指数无明显下降并在手术缝合时氧合指数明显提高，并有统计学意义（P＜0.05）。结论：全麻机械通气中应用个性化PEEP可以优化肺部氧合，具有肺保护的作用。

关键词

全麻；机械通气；个性化；呼气末正压

参考

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