广东医学2024，Vol.45Issue(2)：194-199,6.DOI:10.13820/j.cnki.gdyx.20234017
麻醉苏醒期间不同吸入氧浓度对腹腔镜胃癌根治术患者术后肺不张的影响
Impact of Different Inspired Oxygen Concentrations during Anesthetic Emergence on Postoperative Atelectasis in Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer
摘要
Abstract
Objective To investigate the influence of different inspired oxygen concentrations during anesthetic emergence on postoperative atelectasis in elderly patients undergoing elective laparoscopic radical gastrectomy for gastric cancer.Methods Sixty-eight elderly patients scheduled for elective laparoscopic radical gastrectomy were randomly as-signed to either the high inspired oxygen concentration group(Group C)or the low inspired oxygen concentration group(Group L)with 34 patients in each group.During anesthetic emergence,Group L received 40％inspired oxygen,while Group C received 100％inspired oxygen.Bedside lung ultrasound was used to assess lung ultrasound scores(LUS)in 12 regions(6 in each lung)at entry(T0)and 30 minutes postoperatively(T4).The occurrence of postoperative atelectasis was recorded.Heart rate(HR),mean arterial pressure(MAP),and blood gas analysis including oxygen partial pressure(PaO2)and oxygenation index(OI)were documented at entry(T0),end of pneumoperitoneum(T1),extubation(T2),and PACU discharge(T3).The incidence of SpO2＜94％events in the PACU was recorded.Forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and FEV1/FVC were measured at preoperative day 1(D0)and postop-erative days 1(D,),3(D2),and 5(D3).Clinical Pulmonary Infection Score(CPIS)on postoperative day 1 and the incidence of pulmonary complications on postoperative day 7 were recorded.Results The time from the end of pneumo-peritoneum to extubation was comparable between Group L(36.4±5.2 min)and Group C(37.3±4.2 min)(P＞0.05).Compared with Group C,Group L showed significantly lower LUS and lower incidence of postoperative atelectasis at T4(P＜0.05).At T3,Group L demonstrated significantly increased PaO2 and OI(P＜0.05).The incidence of SpO2＜94％events in the PACU was lower in Group L than in Group C(P＜0.05).Compared with D0,FE V,,FVC,and FEV1/FVC were significantly reduced in both groups on D1-3(P＜0.05).Compared with Group C,Group L showed significantly increased FEV,,FVC,and FEV1/FVC at D,(P＜0.05).There were no significant differences in CPIS on postoperative day 1 and the incidence of pulmonary complications on postoperative day 7 between the two groups(P＞0.05).Conclusion During anesthetic emergence,low inspired oxygen concentration reduces the incidence and severity of postoperative atelectasis in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer,improving early postoperative lung function.关键词
吸入氧浓度/麻醉苏醒期/肺部超声/老年/胃癌/肺功能Key words
inhaled oxygen concentration/emergence/lung ultrasound/elderly/gastric cancer/lung function分类
医药卫生引用本文复制引用
蔡信杰,郭文雅,汪洋,李云..麻醉苏醒期间不同吸入氧浓度对腹腔镜胃癌根治术患者术后肺不张的影响[J].广东医学,2024,45(2):194-199,6.基金项目
安徽高校自然科学研究项目(KJ2019ZD24) （KJ2019ZD24）
