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1、麻醉深度监测下比较异丙酚异氟醚在单肺通气时对肺内分流影响[摘要]目的:在麻醉深度监测下以异丙酚为对照观察异氟醚在单侧肺通气时对肺内分流的影响。方法:择期行右侧开胸的食管癌患者28例,ASAⅠ～Ⅱ级,随机分为异氟醚组和异丙酚组,每组14例。双腔支气管置管成功后,分别以异氟醚、异丙酚维持麻醉,使麻醉深度AAI值维持在预定的20～30之间。手术前平卧位双肺通气20min,平卧位左侧单肺通气40min,分别采集动脉血和混合静脉血行血气分析,计算肺内分流率。结果:在单肺通气后,两组肺内分流率增加明显(P0.05)。结论:排除手术、体位等影响,在相同的麻醉深
2、度下,异氟醚在单肺通气后对肺内分流的影响与异丙酚无差别。�[关键词]异氟醚;异丙酚;肺内分流;单肺通气�[中图分类号]R735.1;R614.2[文献标识码]A[文章编号]1671-7562(2010)04-0380-03�doi:10.3969/j.issn.1671-7562.2010.04.019��Comparisonoftheeffectsofpropofolandisofluraneonintrapulmonary�shuntduringone-lungventilation��LUOXiao-ling�1,CHENShi-biao�2
3、,HUANG6Hai-jin�2(1.DepartmentofAnesthesiology,TheSeventhPeople�sHospitalofShenzhen,Shenzhe518081,China;2.DepartmentofAnesthesiology,ThefirstAffiliatedHospitalofMedicalCollegeofNanchangUniversity,Nanchang330006,China)��[Abstract]Objective:Tostudytheeffectsofpropofolandisofluran
4、eonhypoxicpulmonaryvasoconstriction(HPV)duringone-lungventilation(OLV).Methods:Twenty-eightesophaguscarcinomapatients,ASAⅠtoⅡ,scheduledforselectiverightthoracotomy,wererandomlyassignedintotwogroups:groupP(n=14)andgroupI(n=14).Anesthesiawasinducedwithintravenousetomidate0.25mg・
5、kg-1,fentanyl4μg・kg-1andatracurium0.5mg・kg-1.Left-sideddouble-lumenendobronchialtubewasintubatedorally.ThenanesthesiamaintainedwithinfusionofpropofolingroupP,orwithisofluraneinhalationingroupI.ThespeedofinfusionofpropofolorconcentrationofisofluranewasadjustedaccordingtotheAAIv
6、alue(20～30).MAPandHRweremonitoredduringtheprocedure.6Arterialandmixedvenousbloodsampleweretakenforbloodgasanalysisandintrapulmonaryshunt(Qs/Qt)calculationsbeforesurgery,20minaftertwo-lungventilation,40minafterOLVintwogroups,respectively.Results:AfterOLV,Qs/QtingroupPandgroupIa
7、llincreased(P0.05).Conclusion:AAIvaluemaintainedat20～30,theeffectsofisofluraneonarterialoxygeationandpulmonryshuntfractionaresimilartothoseofpropofolduringOLVventilation.�[Keywords]isoflurane;propofol;pulmonryshuntfraction;one-lungventilation��胸科手术麻醉行单侧肺通气时,非通气侧肺发生低氧性肺血管收缩(HPV
8、)是机体的自主调节过程,但各种麻醉药对HPV具有剂量依赖性的抑制作用,尤其是合并应用挥发性麻醉剂更显著。本研究通过随机分组
