【摘要】：目的觀察術中低潮氣量聯(lián)合不同階段呼氣末正壓通氣(positive end expiratory pressure,PEEP)對老年患者開腹術后肺功能及并發(fā)癥的影響。方法選擇擇期全麻下行開腹手術的老年患者60例,男21例,女39例,年齡≥65歲,ASAⅠ或Ⅱ級,隨機分為三組,每組20例。A組手術開始后1h聯(lián)合PEEP 10cm H_2O持續(xù)1h,B組術畢拔除氣管導管前1h聯(lián)合PEEP 10cm H_2O持續(xù)1h,C組手術全程聯(lián)合PEEP 10cm H_2O。分別于術前、術后1、24h行血氣分析測PaCO_2、PaO_2和A-aDO_2,計算氧合指數(shù)。記錄術前、術后24、72h的氣道分泌物評分。結果與術前比較,術后1h三組PaCO_2明顯升高,B組PaO_2明顯下降,A組A-aDO_2明顯升高(P0.05);術后24hB組、C組PaCO_2明顯升高,B組氧合指數(shù)明顯下降(P0.05)。與術后1h比較,術后24hA組PaCO_2明顯下降,A組A-aDO_2明顯下降(P0.05)。術后三組氣道分泌物評分差異無統(tǒng)計學意義。結論術中低潮氣量聯(lián)合不同階段PEEP能夠改善術后肺的氧合功能,但對術后肺部并發(fā)癥無明顯影響。
[Abstract]:Objective to observe the effects of low tidal volume and positive end-expiratory pressure (positive end expiratory pressure,PEEP) in different stages on pulmonary function and complications after laparotomy in elderly patients. Methods A total of 60 elderly patients (male 21, female 39, age 鈮，

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