压力控制通风-保证体积对接受胸部手术的儿童的影响:一个前性随机对照试验
Lei Wang1, Yi Zhu1, Shili Zhu1
1Department of Anesthesiology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Frontiers in medicine
|October 1, 2025
概括
压力控制通风-保证体积 (PCV-VG) 显著改善了儿科胸部手术的结果. 这种通风模式减少了在单肺通风 (OLV) 期间的肺内分流和术后并发症.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 胸部外科手术 胸部外科手术
- 机械通风机械通风机械通风
背景情况:
- 与成年人相比,使用单肺通风 (OLV) 的儿科胸部手术与较高的发病率和死亡率有关.
- 适当的机械通风模式可以减少这些不良结果.
- 这项研究调查了压力控制通风量保证 (PCV-VG) 在接受胸部手术的儿科患者的疗效.
研究的目的:
- 评估PCV-VG是否可以在OLV期间降低儿科患者的肺内分流 (Qs/Qt).
- 评估PCV-VG对呼吸机引起的肺损伤 (VILI) 的影响.
- 在呼吸参数和术后并发症方面,将PCV-VG与体积控制呼吸 (VCV) 进行比较.
主要方法:
- 接受需要OLV的胸部手术的80名儿童被随机分为PCV-VG和VCV组.
- 主要结局是OLV期间的Qs/Qt分数.
- 二次结局包括呼吸系统参数,血液气体分析和术后肺部并发症 (PPC).
主要成果:
- 在OLV期间,PCV-VG显著改善了Qs/Qt (p < 0.0001).
- 与VCV相比,PCV-VG增强了氧化,降低了气道压力 (p < 0.0001),并降低了PPC的发生率 (p = 0.001).
- 手术后机械通风的持续时间也被PCV-VG缩短 (p = 0.036).
结论:
- 在儿科胸部手术中PCV-VG的实施提供了显著的好处.
- 在OLV期间,PCV-VG改善了Qs/Qt,氧化,并降低了气道压力.
- 这种通风策略有效地缓解VILI,并减少儿科患者的术后并发症.
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