反比通气对肺叶切除婴儿单肺通气时肺功能的影响

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Abstract Objective To investigate the effect of inverse ratio ventilation （IRV） on pulmonary ventilation and exchange function in infants with pulmonary lobectomy during one lung ventilation（OLV）. Methods A total of 66 infants of Guangdong Women and Children′s Hospital with thoracoscopic lobectomy were selected from October 2017 to October 2018, while they were divided into the inverse ventilation group and the conventional ventilation group by random number table method, with 33 infants in each group. The respiratory mechanics indexes of the infants′ threshold limit ventilation (TLV) 15 min (T1), OLV 30 min (T2), OLV 60 min (T3), and recovery TLV 15 min (T4) were recorded, and blood gas analysis was performed. Results Peak airway pressure (Ppeak), mean airway pressure (Pmean), arterial carbon dioxide partial pressure (PaCO2), pulmonary alveolar arterial oxygen partial pressure difference (PA-aO2), respiratory index (RI), void rate (VD/VT) at T2 and T3 were higher than those at T1, while the dynamic lung compliance (Cdyn), pH, arterial blood oxygen partial pressure (PaO2), oxygenation index (OI) were lower than those at T1, and the differences were statistically significant (P ＜ 0.05). Pmean, Cdyn, PaO2, OI in the inverse ventilation group at T2 and T3 were higher than those in the conventional ventilation group, while Ppeak, PaCO2, PA-aO2, and RI were lower than those in the conventional ventilation group, and the differences were statistically significant (P ＜ 0.05). In addition to Ppeak and pH, there were interaction between other indicators of the two groups. There were no statistically significant difference in postoperative hypoxemia between the two groups (P ＞ 0.05). In addition, there was no complications such as delayed recovery, atelectasis and pneumothorax in the two groups. Conclusion IRV applied to infants with single lung ventilation under thoracoscope lobectomy can increase lung compliance, reduce Ppeak, improve lung diffusion function, and promote oxygenation to a certain extent.

Key words： Inverse ratio ventilation One lung ventilation Thoracoscope Infants Pulmonary function

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	WANG Yun LI Yongle FANG Qin HAN Baoyi LIU Jing HU Zurong

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WANG Yun LI Yongle FANG Qin HAN Baoyi LIU Jing HU Zurong. Effect of inverse ratio ventilation on pulmonary function in infants with pulmonry lobectomy during one lung ventilation[J]. 中国医药导报, 2020, 17(13): 118-121.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I13/118

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