兰州大学学报（医学版）2025，Vol.51Issue(12)：35-41,49,8.DOI:10.13885/j.issn.2097-681X.2025.12.005
低浓度氧预氧合联合个体化呼气末正压对全凭静脉麻醉后肺不张的影响
Impact of low concentration oxygen preoxygenation in conjunction with individualized peep on post-operative atelectasis in total intravenous anesthesia
摘要
Abstract
Objective To investigate the effect of low concentration oxygen preoxygenation combined with in individualized positive end-expiratory pressure on postoperative atelectasis in patients under total intravenous anesthesia.Methods A total of 80 patients undergoing laparoscopic cholecystectomy at The First Hospital of Lanzhou University from August to October 2024 were randomly assigned to four groups(I100,I80,I60,and I40)based on inspired oxygen concentrations(100%,80%,60%,and 40%).The changes in lung compliance were measured by increasing the tidal volume,and the best lung compliance was obtained,which was then used to guide the titration of individualized positive end-expiratory pressure.Preoperative and postoperative lung ultra sound scores,pulse oxygen saturation,inspired oxygen concentration,oxygenation index,blood pressure,lung compliance,heart rate,and inflammatory markers(interleukin-6,interleukin-8,interleukin-10 and malondial dehyde)were recorded during anesthesia.Results There were no significant differences in preoperative lung ultrasound scores(P>0.05);postoperative lung ultrasound scores were significantly higher in the I80 and I100 groups compared to the I40 group;the I100 group also showed significantly higher scores than the I60 group(P<0.05);statistically significant differences were observed in preoperative and postoperative lung ultrasound scores across all groups;the changes in lung ultrasound scores before and after surgery were smaller in the I40 group compared to the I100 group,with a statistical significance.Conclusion Low concentration oxygen preox-ygenation combined with individualized positive end-expiratory pressure during total intravenous anesthesia effectively reduces atelectasis without increasing intraoperative hypoxemia.关键词
吸入氧浓度/呼气末正压/超声/肺顺应性/肺不张/全凭静脉麻醉Key words
inhaled oxygen concentration/positive end-expiratory pressure/ultrasound/lung compliance/atel-ectasis/total intravenous anesthesia分类
医药卫生引用本文复制引用
孙燚博,张梓萱,鲁琪瑞,赵雯,王永琦..低浓度氧预氧合联合个体化呼气末正压对全凭静脉麻醉后肺不张的影响[J].兰州大学学报（医学版）,2025,51(12):35-41,49,8.基金项目
甘肃省自然科学基金资助项目(17JR5RA264) （17JR5RA264）
兰州大学第一医院院内基金资助项目(LDYYYN2023-17) （LDYYYN2023-17）
