分子影像学杂志2025，Vol.48Issue(3)：371-378,8.DOI:10.12122/j.issn.1674-4500.2025.03.18
个体化呼气末正压对胸腔镜肺癌手术患者苏醒期呼吸力学、氧合及术后并发症的影响:基于EIT技术
Effects of individualized PEEP on respiratory mechanics during recovery,oxygenation and postoperative complications in patients undergoing thoracoscopic lung cancer surgery:based on EIT
摘要
Abstract
Objective To explore the effects of individualized positive end expiratory pressure(PEEP)based on electrical impedance tomography(EIT)on respiratory mechanics during recovery,oxygenation and postoperative complications in patients undergoing thoracoscopic lung cancer surgery.Methods According to random number table method,84 patients undergoing thoracoscopic lung cancer surgery in the hospital were divided into control group(routine PEEP-fraction of inspired oxygen)and experimental group(individualized PEEP titration based on EIT)between October 2022 and October 2024,including 42 cases per group.The differences in respiratory mechanics,oxygenation function and hemodynamics at different time points during recovery[immediately after entering the recovery room(T1),30min of mechanical ventilation(T2),after awaking(T3)],postoperative rehabilitation indexes and incidence of complications within 1 week were compared between the two groups.Results The intraoperative PEEP and optimal PEEP in recovery room in experimental group were higher than those in control group(P<0.05).At T1,there was no significant difference in dynamic compliance(Cdyn),peak airway pressure(Ppeak),plateau pressure(Pplat),ΔP or oxygenation index(OI)between the two groups(P>0.05).Compared with T1,Cdyn and OI were increased in both groups at T2 and T3,which were higher in experimental group than control group(P<0.05),while Ppeak,Pplat and ΔP were decreased,which were lower in experimental group than control group(P<0.05).From T1-T3,there was no significant difference in partial pressure of carbon dioxide,mean arterial pressure,central venous pressure or heart rate between the two groups(P>0.05).The extubation time,awaking time and length of hospital stay in experimental group were shorter than those in control group(P<0.05).Within 1 week after surgery,incidence of hypoxemia,ventilator-associated lung injury and postoperative pulmonary complications in experimental groups was lower than that in control group(P<0.05).Conclusion Individualized PEEP based on EIT can effectively improve respiratory mechanics and oxygenation function during recovery,reduce postoperative complications and improve recovery quality in patients undergoing thoracoscopic lung cancer surgery,without significant effects on hemodynamics.关键词
肺癌/胸腔镜肺癌根治术/电阻抗断层成像技术/呼气末正压/呼吸力学/氧合指数/并发症Key words
lung cancer/thoracoscopic radical resection of lung cancer/electrical impedance tomography/positive end-expiratory pressure/respiratory mechanics/oxygenation index/complication引用本文复制引用
江倩,李强,刘世建..个体化呼气末正压对胸腔镜肺癌手术患者苏醒期呼吸力学、氧合及术后并发症的影响:基于EIT技术[J].分子影像学杂志,2025,48(3):371-378,8.基金项目
医疗质量循证管理持续改进研究项目(YLZLXZ22G041) （YLZLXZ22G041）
自贡市科技计划项目(2023YLWS22) （2023YLWS22）
