开胸单肺通气时肺部的保护性通气策略及其对炎性因子的影响

张文一

（成都航天医院，四川成都，610100）

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摘要：

目的 分析开胸手术之后的肺部保护性通气策略及其对炎性因子产生的影响。方法 将40例行食管癌根治手术患者随机分成一般常规通气组(CV组)和保护性通气组(PV组)，每组20例。结果 治疗后，两组患者IL-6和IL-8的浓度在T2、T3时点都比T1时有所升高，而在T2、T3点时，PV组患者IL-6和IL-8的浓度明显低于CV组，差异具有统计学意义(P<0.05)。治疗后通过测量得出CV组的气道峰压、平台压、气道阻力的测量数据分别为(33.5±5.1)cmH2O，(21.8±.1)cmH2O，(25.6±.1)cmH2O/(L·s)，PV组的气道峰压、平台压、气道阻力的测量数据分别为(26.1±4.2)cmH2O，(12.8±2.3)cmH2O，(18.6±2.7)cmH2O/(L·s)，PV组明显均低于CV组，差异具有统计学意义(P<0.05)。结论 开胸手术单肺通气期间，采用肺保护性通气策略可以明显降低IL-6和IL-8的浓度，减少开胸手术单肺通气期间以及手术之后的肺炎反应。

关键词：开胸单肺通气；肺保护性通气策略；炎性反应

中图分类号：R563.8文献标志码：A文章编号：2096-1413(2017)01-0034-02

The effect of lung protective ventilation strategy on inflammatory factors during one lung ventilation
ZHANG Wen-yi
(Chengdu Aerospace Hospital, Chengdu 610100, China)

ABSTRACT: Objective To explore the effect of lung protective ventilation strategy on inflammatory factors during one lung ventilations. Methods Forty patients with esophageal cancer were randomly divided into two groups, the conventional ventilation group and the protective ventilation group, with 20 cases in each group. Results After treatment, the IL-6 and IL-8 concentration at T1 point were higher than those of T2 and T3 point, and the IL-6 and IL-8 concentration of PV group were lower than those of CV group at T2 and T3 point, the differences were significant (P<0.05). The peak airway pressure, plateau pressure, airway resistance measurement data of the CV group were (33.5±5.1) cmH2O, (21.8±3.1) cmH2O, (25.6± 2.1) cmH2O/(L·s), while the peak airway pressure, plateau pressure, airaay resistance measured data of the PV group were (26.1±4.2) cmH2O, (12.8±2.3) cmH2O, (18.6±2.7) cm H2O/(L·s), the above date of the PV group were significantly lower than those of the CV group, the differences were statistically significant (P<0.05). Conclusion during one lung ventilation, lung protective ventilation strategy can significantly reduce the concentration of IL -8 and IL -6, reduce the pneumonia response during one lung ventilation and after surgery.
KEYWORDS: open chest one lung ventilation; lung protective ventilation strategy; inflammatory response

 

参考文献：

[1] 林文前,陆霄云,操隆辉,等.肺保护性通气策略对开胸单肺通气时炎性因子的影响[J].癌症,2008,27(8):870-873.

[2] 马武华,高婉菱,关键强,等.单肺通气时预防低氧血症及肺内分流的临床研究[J].中山大学学报:医学科学版,2003,24(1):81-84.