| 摘要: |
| 目的 探讨术前分钟最大通气量(MVV)对行脊柱矫形手术的患者围手术期肺功能及愈后的影响。方法 选取我院2019年6月至2020年6月收治的60例脊柱矫形手术患者,按术前肺功能MVV占预计值百分比进行分组,MVV>50%预计值为正常组(A 组), 30% 2)、二氧化碳分压(PaCO2)、氧合指数(OI)、气道平台压(Pplat)和气道阻力(AR)。手术结束记录患者转入ICU几率,自主呼吸恢复时间、术后带管时间，随访术后第3天(t1)、第7天(t2)患者动脉血氧分压和IL-6、PCT、CRP炎症因子情况。结果 两组患者在T1、T2和T3时间点的PaO2、OI较TO明显降低,气道平台压和气道阻力明显升高。在T2和T3时间点A气道平台压和气道阻力明显低于B组,PaO2和0I明显高于B组,差异有统计学意义(P<0.05)。B组患者自主呼吸恢复时间、术后拔管时间长于A组,差异有统计学意义(P<0.05)。两组患者术后t1时点PaO2、OI比较差异有统计学意义,B组患者PaO2、0I低于A组;两组患者术后t2时点PaO2和炎症因子比较差异无统计学意义。结论 术前 MVV可预测脊柱矫形手术患者术中肺功能及术后复苏时间,肺功能中度损伤并不会影响患者远期预后。| |
| 关键词: 脊柱矫形手术 术前分钟最大通气量 肺功能 围术期 |
| DOI：10.16252/j.cnki.issn1004-0501-2021.01.002 |
| 分类号: |
| 文章编号:1004-0501(2021)01-0006-04 |
| 文献标识码:A |
| 基金项目:四川省卫生健康科研课题普及项目(编号:19PJ210) |
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| Effect of Preoperative MVV on Perioperative Lung Function and Prognosis in Patients Undergoing Spinal Orthopedic Surgery. |
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Yu Mingshuai, Zhang Ke, Liu Siyuan, Qi Lei
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Department of Anesthesiology, Nuclear Industry 41 6. Hospital, the Second Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610051 , China.
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| Abstract: |
| Objective To investigate effects of preoperative maximum minute ventilation volume(MVV)onperioperativelung function and prognosisof patients undergoing spinal orthopedic surgery.Methods From June 2019 to June 2020, 60 patients undergoing spinal orthopedic surgery in our hospitalwere selected and divided into groups according to percentage of perioperative lung function MVV to predicted value. The predicted value of MVV>50% was normal group(group A), 30 % < MVV<50%was moderately impaired lung function group( group B). All patients underwent anesthesia combined intravenous injection with in-halation. Arterial oxygen partial pressure( PaO2) , carbon dioxide partial pressure( PaO2) , oxygenation index( OI) , airway plat-eau pressure( Pplat ) and airway resistance( AR ) were observed at 4 time points , including before operation( T0), 1h(T1), 2h( T2)and end of operation( T3). After operation, thosevalues were recorded , including probability of being transferred to ICU,spontaneous breathing recovery time, post-operative tube time, PaO2, at 3rd day(t1 ) and 7th day( t2 ) after operation, IL-6, PCTand CRP. Results PaO2, and OI of two groups at Tl, T2, and T3 were significantly lower than To, and airway plateau pressureand airway resistance were significantly increased. At T2 and T3, the airway plateau pressure and airway resistance of group Awere significantly lower than those of group B, and PaO2, and OI were significantly higher than those of group B with statisticallysignificantdifference(P <0.05). Recovery time of spontaneous breathing and postoperative extubation in group B were longer thanthose in group A with statistically significant difference( P<0.05). There were statistically significant differences in PaO2, and OIat tl. PaO2, and OI in group B were lower than those in group A. There was no significant difference in PaO2, and inflammatory fac-tors at t2. ConclusionFor patients undergoing spinal orthopedic surgery , preoperative MVV could predict lung function and post-operative resuscitation time. Moderate lung function impairment would not affect long-term prognosis. |
| Key words: spinal orthopedic surgery maximum preoperative minute ventilation lung function perioperative period |
