[1]韩敬泉,李玉嶂,曹守强,等.肥胖对胸腔镜肺叶切除单肺通气时低氧血症的影响[J].中国微创外科杂志,2018,18(3):217-219.
　Han Jingquan,Li Yuzhang,Cao Shouqiang,et al.Effects of Obesity on Arterial Oxygenation During One Lung Ventilation in Thoracoscopic Pulmonary Lobectomy[J].Chinese Journal of Minimally Invasive Surgery,2018,18(3):217-219.
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肥胖对胸腔镜肺叶切除单肺通气时低氧血症的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年3期
页码:
217-219
栏目:
临床研究
出版日期:
2018-05-01

文章信息/Info

Title:
Effects of Obesity on Arterial Oxygenation During One Lung Ventilation in Thoracoscopic Pulmonary Lobectomy
作者:
韩敬泉; 李玉嶂; 曹守强; 董庆; 赵桂彬; 崔键**
哈尔滨医科大学附属第四医院胸外科，哈尔滨150001
Author(s):
Han Jingquan;  Li Yuzhang;  Cao Shouqiang;  et al.
Department of Thoracic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
关键词:
肥胖; 胸腔镜; 单肺通气; 低氧血症
Keywords:
Obese; Thoracoscopy; One lung ventilation; Hypoxemia
文献标志码:
A
摘要:
目的探讨胸腔镜肺叶切除术中肥胖对单肺通气时低氧血症的影响。方法2015年9月~2016年3月拟行胸腔镜肺叶切除的32例肺癌被纳入研究，BMI≥30.0为肥胖组（n=16），BMI<26.0为对照组（n=16）。每组又分为左侧单肺通气和右侧单肺通气，记录单肺通气时最低PaO2值。 结果肥胖组单肺通气时PaO2最低值为（122.3±22.8）mm Hg，显著低于对照组单肺通气时PaO2最低值（219.2±39.4）mm Hg（t=-8.515，P=0.000)。肥胖组左侧单肺通气PaO2最低值明显低于右侧单肺通气（t=-8.064，P=0.000)，对照组具有同样的倾向（t=-2.155，P=0.049)。结论肥胖患者单肺通气时会产生更严重的低氧血症，特别是对于右侧肺叶切除（左侧单肺通气）患者更加明显。
Abstract:
ObjectiveTo investigate effects of obesity on arterial oxygenation during one lung ventilation (OLV) in thoracoscopic pulmonary lobectomy.MethodsFrom September 2015 to March 2016, a total of 32 patients scheduled for thoracoscopic pulmonary lobectomy were included. The patients with body mass index (BMI) ≥ 30 were included in the obese group (n=16) while patients with BMI<26.0 were included in the control group (n=16). Each group was given left or right one lung ventilation. We performed consecutive measurements of arterial oxygen tension (PaO2) during one lung ventilation. ResultsThe minimum value of PaO2 during one lung ventilation was significantly less in the obese group (122.3±22.8) mm Hg than that in the control group (219.2±39.4) mm Hg (t=-8.515, P=0.000). In the obese group, the PaO2 value was significantly lower in left lung ventilation than that in right lung ventilation (t=-8.064, P=0.000). The control group had the same tendency (t=-2.155, P=0.049).ConclusionAs compared with patients with normal body weight, obese patients have a more severe hypoxemia during one lung ventilation, especially in the right sided lobectomy.

参考文献/References:

[1]Chlif M, Keochkerian D, Choquet D, et al. Effects of obesity on breathing pattern, ventilatory neural drive and mechanics. Respir Physiol Neurobiol,2009,168 (3):198-202.
[2]Dreher M, Kabitz HJ. Impact of obesity on exercise performance and pulmonary rehabilitation. Respirology,2012,17(6):899-907.
[3]McClean KM, Kee F, Young IS, et al. Obesity and the lung: 1. Epidemiology. Thorax,2008,63(7):649-654.
[4]Crummy F, Piper AJ, Naughton MT. Obesity and the lung: 2. obesity and sleepdisordered breathing.Thorax,2008,63(8):738-746.
[5]Smith PW, Wang H, Gazoni LM, et al. Obesity does not increase complications after anatomic resection for nonsmall cell lung cancer. Ann Thorac Surg,2007,84(4):1098-1106.
[6]宋楠,姜格宁,王海,等.肥胖对肺切除术后并发症发生的影响.中国胸心血管外科临床杂志,2013,20(l):74-77.
[7]张六伢，李远静，陈维，等.全胸腔镜肺叶切除对腹型肥胖低肺功能肺癌患者术后心肺功能的影响.中国微创外科杂志,2015,15(10):917-921.
[8]Sebbane M, El Kamel M, Millot A, et al. Effect of weight loss on postural changes in pulmonary function in obese subjects: a longitudinal study. Respir Care,2015,60(7):992-999.
[9]Steier J, Lunt A, Hart N, et al. Observational study of the effect of obesity on lung volumes. Thorax,2014,69(8):752-759.
[10]Pellegrino R, Gobbi A, Antonelli A， et al. Ventilation heterogeneity in obesity. J Appl Physiol,2014,116(9):1175-1181.
[11]Mosing M, German AJ, Holden SL, et al. Oxygenation and ventilation characteristics in obese sedated dogs before and after weight loss: a clinical trial. Vet J,2013,198(2):367-371.
[12]Campbell PT. Obesity: a certain and avoidable cause of cancer. Lancet,2014,384(9945):727-728.
[13]Pelosi P, Gregoretti C. Perioperative management of obese patients. Best Pract Res Clin Anaesthesiol,2010,24(2):211-225.
[14]Leonard KL, Davies SW, Waibel BH. Perioperative management of obese patients. Surg Clin North Am,2015,95(2):379-390.
[15]Satoh D, Kurosawa S, Kirino W, et al. Impact of changes of positive endexpiratory pressure on functional residual capacity at low tidal volume ventilation during general anesthesia. J Anesth,2012,26(5):664-669.
[16]Reinius H, Jonsson L, Gustafsson S, et al. Prevention of atelectasis in morbidly obese patients during general anaesthesia and paralysis: a computerized tomography study. Anesthesiology,2009,111(5):979-987.
[17]Pelosi P, Croci M, Ravagnan I, et al. Respiratory system mechanics in anesthetized, paralyzed, morbidly obese patient. J Appl Physiol,1997, 82(3):811-818.
[18]Okamoto K, Kochi K, Yoshizaki S, et al. Arterial oxygenation during one lung ventilation in obese patients. Masui,1999,48(2):168-171.

备注/Memo

备注/Memo:
基金项目：哈尔滨市科技局青年后备人才项目(2015RAQYJ095)**通讯作者，E-mail:jiancui99999@126.com
更新日期/Last Update: 2018-05-10