针对性控制的压力控制通风对全身麻醉下的皮肤透气性神经透症患者的影响:一项回顾性研究
Yong Tao1, Guowei Ma1, Tingting Sun1
1Department of Surgical Anesthesia, The First People's Hospital of Shuangliu District (West China Airport Hospital of Sichuan University), Chengdu, China.
Translational andrology and urology
|June 12, 2023
概括
目标控制的压力控制通风 (PCV) 显著减少了易受手术患者的术后肺部并发症和炎症. 与固定比率PCV相比,这种方法改善了肺机械和患者的结果.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 手术重症监护手术重症监护
背景情况:
- 在手术期间俯卧可能会损害肺部机制,增加术后肺部并发症 (PPC) 的风险.
- 目前的机械通风指导方针对于容易手术缺乏.
- 卧卧的穿皮性结石,会带来特定的通风挑战.
研究的目的:
- 为了评估目标控制的压力控制通风 (PCV) 的有效性,使用终端吸气流量.
- 为了比较易发生皮肤穿透性神经缩症的患者的目标控制PCV与固定呼吸比率PCV.
- 评估对PPC,肺机械和炎症标志物的影响.
主要方法:
- 对154名接受易患皮肤穿性神经缩症的患者进行了回顾性研究.
- 分配给固定呼吸比率PCV (n=78) 或目标控制PCV (n=76) 的患者.
- 血液动力学,PPC和血清炎症标志物的比较 (IL-6,CRP).
主要成果:
- 在目标控制的PCV组中,PPC的发病率较低 (3.95%对14.10%,P=0.028).
- 在目标控制的PCV组中,在术后观察到改善的肺机械 (降低峰值/平原气道压力,增加动态遵守).
- 在目标控制的PCV组中,术后IL-6和CRP水平显著降低.
结论:
- 具有终端吸入流速的目标控制PCV优于易受手术的固定呼吸比率PCV.
- 这种通风策略有效地减少了PPC和全身炎症.
- 它提供了改善的肺部保护和患者在易患皮肤穿性神经缩症的结果.
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