不同通气模式对老年患者腹腔镜直肠癌手术血流动力学的影响

雷 杨, 植 王, 汝泓 李

摘要


目的:采用 FloTrac/Vigileo 监测系统观察容量控制通气(VCV)和压力控制容量保证通气(PCV-VG)模式对老年患者腹腔镜直肠癌手术血流动力学的影响。方法:选取择期行腹腔镜直肠癌手术患者 60 例,年龄 65~80 岁,BMI18~30kg/m2,ASA 分级Ⅰ ~ Ⅲ级,采用随机数字表法将患者分为两组:VCV 组(V 组)和 PCV-VG 组(P 组),每组 30 例。记录患者在麻醉诱导完成后 10min,建立气腹前(T0),气腹后 10min(T1),气腹后 30min(T2),气腹后 60min(T3),手术结束时(T4)的平均动脉压(MAP),心率(HR),心脏指数(CI),每搏变异度(SVV),每搏变异指数(SVI)。结果:两组患者在不同时点 HR、SVI 无明显改变(P > 0.05),与 T0 比较,T1~T3 时两组患者 MAP、SVV 明显升高(P < 0.05)。与 V 组比较,T1~T3 时 SVV 明显降低,T0~T4 时 P 组 CI 更趋于稳定。结论:在老年患者腹腔镜直肠癌手术中,PCV-VG 通气模式更有利于减少患者血流动力学的波动。

关键词


压力控制容量保证通气;老年患者;腹腔镜;血流动力学

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参考


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DOI: https://doi.org/10.12346/pmr.v4i2.6088

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