超声指导的个性化正极呼吸压对老年患者手术后骨质疏松症的严重程度的影响:一项随机对照研究
Junyang Ma1,2, Meiqi Sun3, Fengxiang Song1
1Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medicine University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China.
超声导向的个性化阳性末尾呼气压 (PEEP) 在经过腹腔镜手术的老年患者中显著降低了术后的骨质疏通和肺部并发症. 这种方法改善了肺部通风,降低了死亡风险.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
背景情况:
- 手术后的肺部并发症 (PPC),特别是脱血症,是全身麻醉患者死亡和长时间住院的重要原因.
- 接受重大手术的老年患者患PPC的风险更高,需要改进预防策略.
研究的目的:
- 调查超声导向的个性化阳性末尾呼气压 (PEEP) 定位是否可以降低经过腹腔镜手术的老年患者的手术后脱氧.
- 为了比较个人化PEEP和固定PEEP组之间的PPC发病率.
主要方法:
- 一个单中心随机对照试验,涉及89名老年患者,计划进行腹腔镜结肠直肠癌手术.
- 患者被随机分为两个组:一个个性化的PEEP组 (超声波导向定位) 和一个固定PEEP组 (5cmH2O).
- 肺超声波得分 (LUSs) 用于在术后评估肺通风和透症的严重程度.
主要成果:
- 与固定PEEP组相比,个性化PEEP组在手术后7天内显著减少了LUS和改善了阿特莱克塔斯严重程度 (P <0.05).
- 在个性化PEEP组 (48.6%) 与固定PEEP组 (77.8%;RR = 0.625;P = 0.01) 中,PPC的发生率明显较低.
结论:
- 超声导向的个性化PEEP定位是缓解腹腔镜手术的老年患者手术后脱的有效策略.
- 这种方法可以显著降低术后肺部并发症的发生率,有助于改善患者的治疗结果.
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