驾驶压力引导的潮体积定位可以减少胸部手术中的肺损伤,使用单肺通风:一项随机临床试验
Yun Yan1, Xiaowen Liu2, Zhen Liu2
1Department of Anesthesiology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China.
Journal of cardiothoracic and vascular anesthesia
|December 18, 2025
概括
驾驶压力导向通风可以减少胸部手术期间的肺损伤. 这种方法在单肺通风 (OLV) 后降低了依赖性肺中的插白素-6 (IL-6) 水平,为患者提供了更安全的方法.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 对于接受单肺通风 (OLV) 的胸部手术患者,最佳的潮体积尚未得到充分确立.
- 在这些程序中,肺部损伤仍然是一个问题.
研究的目的:
- 评估驱动压力引导的潮体积定位是否可以减少OLV期间的肺损伤.
- 为了比较驾驶压力导向通风与传统的潮体积设置.
主要方法:
- 前性,单中心,随机对照试验,涉及96名接受OLV胸部手术的患者.
- 患者被随机分配到驱动压力引导组 (8-10厘米H2O) 或对照组 (8毫升/公斤预测体重).
- 在驱动压力组中,潮体积调整为4-8mL/kgPBW.
主要成果:
- 驱动压力导向组在依赖性肺部后OLV (5.31对7.37;p=0.025) 中显示了显著较低的互白素-6 (IL-6) 度.
- 驱动压力组的潮体积平均为4.65毫升/公斤PBW.
- 两组之间没有观察到术后肺部并发症或氧化指数的显著差异.
结论:
- 驱动压力引导的潮体积定位有效降低OLV后依赖肺部的IL-6水平.
- 这种方法优于使用8毫升/公斤PBW的常规通风来缓解胸部手术患者的肺炎.
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