中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
2期
237-238
,共2页
蒋红梅%张洁%朱凤鸣%王建越%董明远
蔣紅梅%張潔%硃鳳鳴%王建越%董明遠
장홍매%장길%주봉명%왕건월%동명원
全身麻醉%潮气量%俯卧位
全身痳醉%潮氣量%俯臥位
전신마취%조기량%부와위
General anesthesia%Tide volume%Prone position
目的 探讨全身麻醉不同潮气量对俯卧位手术患者血清中CC16表达的影响.方法 将行俯卧位脊柱全身麻醉手术患者80例完全随机分为4组,每组20例.另选20例在硬膜外麻醉下行俯卧位手术的患者为对照组.Ⅰ组设定潮气量12 ml/kg,呼吸频率8次/min;Ⅱ组潮气量10 ml/kg,呼吸频率10次/min;Ⅲ组潮气量8 ml/kg,呼吸频率12次/min;Ⅳ组潮气量6ml/kg,呼吸频率14次/min.手术开始前及结束后抽取静脉血2ml送检,采用双抗体两步夹心酶联免疫吸附法测定CC16含量.结果 Ⅰ、Ⅳ组术后CC16低于本组术前及对照组术后[Ⅰ组:(34±15) mg/L比(40±16)、(40±15) mg/L;Ⅳ组:(33±16) mg/L比(40±16)、(40±15) ag/L;均P＜0.05],Ⅱ、Ⅲ组术后CC16与本组术前及对照组术后比较差异无统计学意义[Ⅱ组:(41±16) mg/L比(42±16)、(40±15) mg/L;Ⅲ组:(40±17) mg/L比(40±16)、(40±15) μg/ml;均P＞0.05].结论 全身麻醉俯卧位手术患者在间歇正压通气模式下设定潮气量8 ml/kg、呼吸频率12次/min时,CC16手术前后变化最小,该组通气模式对肺脏损伤最小,有利于围手术期肺脏保护.
目的 探討全身痳醉不同潮氣量對俯臥位手術患者血清中CC16錶達的影響.方法 將行俯臥位脊柱全身痳醉手術患者80例完全隨機分為4組,每組20例.另選20例在硬膜外痳醉下行俯臥位手術的患者為對照組.Ⅰ組設定潮氣量12 ml/kg,呼吸頻率8次/min;Ⅱ組潮氣量10 ml/kg,呼吸頻率10次/min;Ⅲ組潮氣量8 ml/kg,呼吸頻率12次/min;Ⅳ組潮氣量6ml/kg,呼吸頻率14次/min.手術開始前及結束後抽取靜脈血2ml送檢,採用雙抗體兩步夾心酶聯免疫吸附法測定CC16含量.結果 Ⅰ、Ⅳ組術後CC16低于本組術前及對照組術後[Ⅰ組:(34±15) mg/L比(40±16)、(40±15) mg/L;Ⅳ組:(33±16) mg/L比(40±16)、(40±15) ag/L;均P＜0.05],Ⅱ、Ⅲ組術後CC16與本組術前及對照組術後比較差異無統計學意義[Ⅱ組:(41±16) mg/L比(42±16)、(40±15) mg/L;Ⅲ組:(40±17) mg/L比(40±16)、(40±15) μg/ml;均P＞0.05].結論 全身痳醉俯臥位手術患者在間歇正壓通氣模式下設定潮氣量8 ml/kg、呼吸頻率12次/min時,CC16手術前後變化最小,該組通氣模式對肺髒損傷最小,有利于圍手術期肺髒保護.
목적 탐토전신마취불동조기량대부와위수술환자혈청중CC16표체적영향.방법 장행부와위척주전신마취수술환자80례완전수궤분위4조,매조20례.령선20례재경막외마취하행부와위수술적환자위대조조.Ⅰ조설정조기량12 ml/kg,호흡빈솔8차/min;Ⅱ조조기량10 ml/kg,호흡빈솔10차/min;Ⅲ조조기량8 ml/kg,호흡빈솔12차/min;Ⅳ조조기량6ml/kg,호흡빈솔14차/min.수술개시전급결속후추취정맥혈2ml송검,채용쌍항체량보협심매련면역흡부법측정CC16함량.결과 Ⅰ、Ⅳ조술후CC16저우본조술전급대조조술후[Ⅰ조:(34±15) mg/L비(40±16)、(40±15) mg/L;Ⅳ조:(33±16) mg/L비(40±16)、(40±15) ag/L;균P＜0.05],Ⅱ、Ⅲ조술후CC16여본조술전급대조조술후비교차이무통계학의의[Ⅱ조:(41±16) mg/L비(42±16)、(40±15) mg/L;Ⅲ조:(40±17) mg/L비(40±16)、(40±15) μg/ml;균P＞0.05].결론 전신마취부와위수술환자재간헐정압통기모식하설정조기량8 ml/kg、호흡빈솔12차/min시,CC16수술전후변화최소,해조통기모식대폐장손상최소,유리우위수술기폐장보호.
Objective To investigate the effect of different tide volume on serum clara cell secretary protein (CC16) concentration in patients undergoing general anesthesia in prone position.Methods All 80 patients underwent spinal surgery in general anesthesia were randomly divided into four groups and each group of 20 cases.tidal volume of patients in group Ⅰ was 12 ml/kg,breathing rate was 8 times/min; tidal volume was 10 ml/kg and breathing rate was 10 times/min in group Ⅱ; tidal volume was 8 ml/kg,breathing rate was 12 times/min in group Ⅲ;tidal volume was 6 ml/kg and breathing rate was 14 times/min in group Ⅳ.20 cases underwent operation of a prone position in the epidural anesthesia as a control group.The serum concentration of CC16 was measured by enzymelinked immunoadsorption before operation and postoperation.Results Postoperative serum concentration of CC16 in group Ⅰ and group Ⅳ was significant lower than preoperative serum concentration of CC16,and postoperative in control group [group Ⅰ:(34 ± 15)mg/L vs (40 ± 16),(40 ± 15)mg/L; group Ⅳ:(33 ± 16)mg/L vs (40 ± 16),(40 ± 15)mg/L; all P ＜0.05].The serum concentration of CC16 in group Ⅱ and group Ⅲ was no significant compared with preoperative serum concentration of CC16,and postoperative in control group [group Ⅱ:(41 ± 16)mg/L vs (42 ±16),(40±15)mg/L; group Ⅲ:(40 ± 17)mg/L vs (40±16),(40 ± 15)mg/L; all P＞0.05].ConclusionsThe most suitable ventilation modes for surgery patients on prone position during general anesthesia is tidal volume 8 ml/kg and breathing rate 12 times/min.The changes of CC16 is minimum before and after operation,and the ventilation modes with minimum damage should be helpful for perioperative lung protection.
