标题：保护性通气模式对上腹部肿瘤手术患者肺功能恢复的影响

      作者：舒六一 1，吴 妮 2，赖丽芬 1，刘 方 1
    （海军总医院呼吸科肺功能室 1、干部呼吸科 2，北京 100048）

      卷次： 2015年26卷5期

      【摘要】 目的 分析保护性通气模式对上腹部肿瘤手术患者肺功能恢复的影响。方法 选择在本院接受
上腹部肿瘤手术的患者作为研究对象，随机分为接受容量控制通气模式的对照组和接受保护性通气模式的观察
组各48例，比较两组患者的呼吸力学参数、肺功能指标及血管内皮细胞相关指标的差异。结果 (1)观察组患者
接受保护性通气模式后，气道峰压(Ppeak)，气道平均压(Pmean)，呼气末二氧化碳分压(PETCO2)高于对照组患者，呼吸
系统总阻力(Rrs)低于对照组患者(P<0.05)；(2)观察组患者接受保护性通气模式后肺功能指标，如RI、OI、Cs、Cd均
显著优于对照组患者(P<0.05)；(3)两组患者通气前的vWF与 sICAM-1水平差异均无统计学意义(P>0.05)，接受不
同通气模式后其 vWF与 sICAM-1水平均呈上升趋势，但观察组患者的上升值明显小于对照组患者(P<0.05)。
结论 保护性通气模式可以降低呼吸系统阻力、优化肺功能指标、减少血管内皮细胞损伤，有助于术后患者的肺
功能恢复。

      【关键词】 保护性通气模式；上腹部肿瘤；肺功能

      【中图分类号】 R735 【文献标识码】 A 【文章编号】 1003—6350（2015）05—0661—03


Impact of protective ventilation mode on pulmonary function recovery in patients undergoing abdominal
cancer surgery.
SHU Liu-yi 1, WU Ni 2, LAI Li-fen 1, LIU Fang 1. Pulmonary Function Test Room, Department of
Respiration 1, Department of Cadre Respiration 2, Naval General Hospital of PLA, Beijing 100048, CHINA

【Abstract】 Objective To analyze the impact of protective ventilation mode onpulmonary function recovery
in patients who had received abdominal cancer surgery. Methods Patients received upper abdominal cancer surgery
in our hospital were selected as research subjects, which were randomly assigned to control group (received volume
control ventilation mode) and observation group (received protective ventilation mode), each with 48 cases. The respi-
ratory mechanics parameters, lung function indicators and vascular endothelial were compared between the two
groups. Results (1) After ventilation, Ppeak, Pmean, PETCO2 in the observation group were significantly higher than the
control group, but Rrs level was significantly lower (P<0.05). (2) After ventilation, the patients' lung function indica-
tors such as RI, OI, Cs, Cd in the observation group were significantly better than control group (P<0.05). (3) vWF
and sICAM-1 levels showed no statistically significant difference between the two groups before treatment, and they
were significantly increased after ventilation in the two groups. The increase in the observation group were significant-
ly smaller (P<0.05). Conclusion The protective ventilation mode can reduce respiratory system resistance, optimize
lung function indicators, reduce capillary damage, and help the recovery of lung function.