PEEP对骨肿瘤手术患者全身麻醉期呼吸功能和血流动力学的影响

目的:探讨呼气末正压通气(PEEP)对骨肿瘤手术患者全身麻醉期呼吸功能和血流动力学的影响。方法:选取2014年1月-2015年12月期间我院收治的60例骨肿瘤患者,所有患者给予常规麻醉诱导后连接呼吸机行机械通气,观察并记录不同PEEP通气(0cm H_2O,5cm H_2O和10cm H_2O)下呼吸功能及血流动力学指标。结果:PEEP 10cm H_2O通气水平的气道峰压(Peak)、气道平台压(Plat)显著高于PEEP 5cm H_2O和PEEP 0cm H_2O通气,PEEP 5cm H_2O通气水平的Ppeak和Pplat显著高于PEEP 0cm H_2O通气,差异均有统计学意义(P0.05);不同PEEP通气水平的心率(HR)、平均动脉压(MAP)和中心静脉压(CVP)比较差异无统计学意义(P0.05);不同PEEP通气水平的心脏指数(CI)、每搏指数(SVI)、全心射血分数(GEF)、心脏功能指数(CFI)、每搏变异度(SVV)、脉压变异率(PPV)、胸腔内血容量指数(ITBI)、血管外肺水指数(ELWI)和肺血管通透性指数(PVPI)比较差异无统计学意义(P0.05)。结论:增加PEEP通气值能够显著改善吸功能的Ppeak和Ppla指标,但不影响血流动力学指标,值得临床推广应用。

Effects of PEEP on Respiratory Function and Hemodynamics During General Anesthesia in Patients With Bone Tumor Surgery

ABSTRACT Objective: To investigate effects of PEEP ventilation on respiratory function and hemodynamics during general anes- thesia in patients with bone tumor surgery. Methods: 60 cases of patients with bone tumors were selected during January 2014 to 2015 December in our hospital, all patients were treated with routine anesthesia induction underwent mechanical ventilation, to observe and record the respiratory function and hemodynamic parameters under different PEEP ventilation(0 cm H₂O,5 cm H₂O and 10 cm H₂O). Results: Peak and Plat of PEEP 10 cm H₂O were significantly higher than that of PEEP 5 cm H₂O and PEEP 0 cm H₂O, Peak and Plat of PEEP 5 cm H₂O were significantly higher than PEEP 0 cm H₂O, the difference was statistically significant(P<0.05). The difference of HR, MAP and CVP of different PEEP levels were no statistical significance(P> 0.05). The difference of CI, SVI, GEF, CFI, SVV, PVV, ITBI, ELWI and PVPI of different PEEP levels were no statistical significance(P>0.05). Conclusion: Increased PEEP values can significantly improve the absorption function such as Peak and Plat, but no influence on hemodynamic, which is worthy of clinical application.