[1]蒋明,顾小平,马正良.七氟烷与异氟烷对腹腔镜胆囊切除术中通气功能影响的比较[J].中国微创外科杂志,2009,09(8):714-716.
　Jiang Ming,Gu Xiaoping,Ma Zhengliang..Effects of Sevoflurane and Isoflurane on Ventilation Function during Laparoscopic Cholecystectomy[J].Chinese Journal of Minimally Invasive Surgery,2009,09(8):714-716.
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七氟烷与异氟烷对腹腔镜胆囊切除术中通气功能影响的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年8期
页码:
714-716
栏目:
出版日期:
2009-08-31

文章信息/Info

Title:
Effects of Sevoflurane and Isoflurane on Ventilation Function during Laparoscopic Cholecystectomy
作者:
蒋明; 顾小平; 马正良
南京大学医学院附属鼓楼医院麻醉科，南京210008
Author(s):
Jiang Ming;  Gu Xiaoping;  Ma Zhengliang.
Department of Anesthesiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
关键词:
七氟烷; 异氟烷; 腹腔镜胆囊切除术; 通气功能
Keywords:
Sevoflurane; Isoflurane; Laparoscopic cholecystectomy; Ventilation function
分类号:
R614.2+1；R657.4
文献标志码:
A
摘要:
目的应用旁气流通气监测比较七氟烷与异氟烷对腹腔镜胆囊切除术中通气功能的影响。方法选择ASAⅠ～Ⅱ级40例拟行腹腔镜胆囊切除术的成年患者,随机分成七氟烷组（Ⅰ组）和异氟烷组（Ⅱ组），各组20例,术前用药、麻醉诱导相同。麻醉维持:分别在气管插管后吸入1%七氟烷或异氟烷，同时持续静脉泵入丙泊酚3～5 mg/（kg·h）和阿曲库铵0.3～0.5 mg/（kg·h）。计算2组不同时段肺顺应性比值、气道阻力的变化和死腔率。结果①与平卧位插管后相比，2组气腹后0，15和30 min的肺动态顺应性（Cdyn）降低，气道压（Paw）升高（P<0.05），气腹后30 min死腔率（VD/VT）也明显升高（P<0.05）。②与平卧位插管后相比，2组PaCO2和呼气末CO2分压（PETCO2）在气腹后15，30 min以及排除CO2后明显升高（P<0.05）。③与同一时段七氟烷组相比，异氟烷组排除CO2后的VD/VT、PaCO2明显高于七氟烷组（P<0.05），余2组差异无显著性。结论吸入七氟烷的患者在排除CO2后的肺部死腔率明显小于吸入异氟烷的患者。
Abstract:
ObjectiveTo compare the effects of sevoflurane and isoflurane on ventilation function during laparoscopic cholecystectomy by monitoring side stream spirometry (SSS). Methods Totally 40 adult patients (ASA grade Ⅰ-Ⅱ), who were to undergo laparoscopic cholecystectomy, were randomly divided into sevoflurane group (group Ⅰ) and isoflurane group (group Ⅱ), with 20 cases in each. The two groups were given same preoperative medication and induction of anesthesia. Anesthesia maintenance was performed with inhaling of 1% sevoflurane or 1% isoflurane, combined with continuous intravenous infusion of propofol ［3 to 5 mg/（kg·h)］ and atracurium ［0.3 to 0.5 mg/(kg·h)］. The changes of the lung compliance and Airway resistance of the two groups, as well as dead space ratio, were observed in the two groups. Results① Compared with the patients received intubation at the supine position, the two groups showed reduced pulmonary compliance (Cdyn) and significantly increased airway pressure (Paw, P<0.05) immediately after pneumoperitoneum, the dead space ratio (VD/VT) increased significantly as well (P<0.05) in 30 minutes. ② Compared with the patients underwent intubation at the supine position，both PaCO2 and PETCO2 increased significantly at 15 and 30 minutes after pneumoperitoneum, as well as after the CO2 was released (P<0.05). ③ At the same time points after eliminating CO2, group Ⅱ showed significantly higher levels of VD/VT and PaCO2 than group Ⅰ (P<0.05). No significant difference was detected in other indices between the two groups.ConclusionThe postpneumoperitoneum dead space ratio in patients received sevoflurane is significantly lower that that in those inhaled isoflurane.

参考文献/References:

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备注/Memo

备注/Memo:
顾小平通讯作者
更新日期/Last Update: 2013-09-17