实用医学杂志2026，Vol.42Issue(3)：531-540,10.DOI:10.3969/j.issn.1006-5725.2026.03.023
压力控制容量保证通气模式对心脏瓣膜手术患者呼吸力学、心肌损伤及术后肺部并发症的影响
The influence of pressure regulated volume controlled ventilation mode on respiratory mechanics,myo-cardial injury and postoperative pulmonary complications in patients undergoing cardiac valve surgery
摘要
Abstract
Objective To explore the value of pressure regulated volume-controlled ventilation mode(PRVC)in cardiac valve surgery based on respiratory mechanics,myocardial injury and postoperative pulmonary complications.Methods A prospective study included patients admitted to the affiliated Hospital of Xuzhou Medical University for elective cardiac valve replacement or repair from January 2024 to October 2025.After strict inclusion and exclusion criteria,a total of 100 cases were finally enrolled.Patients were assigned to the PRVC group(n=50)and the control group(n=50,volume-controlled ventilation mode)in a 1∶1 ratio by stratified block randomization.The respiratory mechanics and oxygenation status of the two groups at different times after surgery were compared.The levels of creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),hypersensitive troponin T(hs-cTnT),and N-terminal pro-brain natriuretic peptide(NT-proBNP)before and after surgery were determined.The occurrence of pulmonary complications within 7 days after surgery was recorded.Results At different time points,the Ppeak,Pplat and △P in the PRVC group were all lower than those in the control group,while Cdyn was higher,with intergroup and time effects(P<0.05),and with an interaction effect on Ppeak(P<0.05).At different time points,the PRVC group had higher PaO2 and OI,while lower RI and PA-aO2 were lower,with intergroup and time effects(P<0.05),among which there was an interaction effect of PaO2 and PA-aO2(P<0.05).At 6 hours and 24 hours after surgery,the levels of CK-MB,LDH,hs-cTnT and NT-proBNP in both groups were higher than those before surgery in the same group,and those in the PRVC group were lower.There were intergroup,time and interaction effects(P<0.05).The extubation time,ICU stay time and total hospital stay in the PRVC group were shorter(P<0.05),and the total incidence of postoperative pulmonary complications was significantly lower(P<0.05).Conclusions The PRVC mode used in cardiac valve surgery has less impact on respiratory mechanics and oxygenation than the VCV mode,has a significant lung-protective effect,can reduce myocardial injury and decrease pulmonary complications.关键词
心脏瓣膜手术/通气模式/压力控制容量保证通气/容量控制通气/肺保护/呼吸力学Key words
cardiac valve surgery/ventilation mode/pressure regulated volume-controlled ventila-tion/volume-controlled ventilation/lung protection/respiratory mechanics分类
医药卫生引用本文复制引用
卜林,胡书群,晁亚丽,张胜楠,周敏,徐慧琳..压力控制容量保证通气模式对心脏瓣膜手术患者呼吸力学、心肌损伤及术后肺部并发症的影响[J].实用医学杂志,2026,42(3):531-540,10.基金项目
江苏省卫生健康委员会重点项目(编号:K2023020) （编号:K2023020）
