Effect of Small Tidal Air Volume Lung Protective Ventilation on PostoperativeReintegration of Catients with Incomplete Gastroenteral Surgery for Elderly combined with Pulmonary Dysfunction
GAO Dehong
The People's Hospital of Hanchuan, Hubei Xiaogan 431600, China
Abstract：Objective: To provide guidance for the patients with anesthesia ventilation in the selection process by understanding of gastrointestinal surgery used in lung protective ventilation with low tidal volume to the elderly pulmonary insufficiency results and analysis of the method of difference between the traditional mechanical ventilation. Methods: From February 2012 to December 2016, 140 cases of gastrointestinal surgery admitted in our hospital were randomly divided into control group (traditional mechanical ventilation group) and experimental group (protective ventilation management group), with 70 patients in each group. The operation related indicators (Pplat, Ppeak, PErCO2, Raw, anesthesia time, operative time, operative bleeding volume, transfusion volume and urine volume) of the two groups before and after operation (T0-T4) were compared. The statistical difference of airway monitoring index, oxygen saturation and related indicators (PaO2, PaCO2, OI, Qs/Qt), inflammatory cytokines and related indicators (IL-6, IL-8, TNF-α, CC16, SP-D, sRAGE) of two groups were compared. Results: The differences of Pplat, PErCO2, Raw, time of anesthesia, operation time and bleeding volume of the two groups were statistically significant (P<0.05). The Pplat, PErCO2 and Raw in the experimental group were larger than those in the control group, and the time of anesthesia, the operation time and the amount of bleeding were less than those of the control group. The difference of P peak, P average and CL index in the experimental group and the control group was statistically significant (P<0.05). The difference of P peak (T1, T2, T3), P average (T2, T3), CL (T2, T3, T4) between the two groups were statistically significant (P<0.05). The overall index of the experimental group was less than that of the control group. The differences of PaO2, PaCO2, OI and Qs/Qt in the experimental group and the control group were statistically significant (P<0.05). The differences of PaO2 (T2, T3, T4), PaCO2 (T1, T2, T3, T4) and Qs/Qt between the two groups were statistically significant. The PaO2, PaCO2, OI and Qs/Qt in the control group were less than those in the experimental group. The differences of IL-6, IL-8, TNF- alpha, CC16, SP-D and sRAGE in the experimental group and the control group were statistically significant (P<0.05). The difference of IL-6 (T1, T2), TNF- alpha (T1, T2, T3, T4), CC16 (T1, T2, T3), and the index of between the two groups were statistically significant. The TNF-alpha, CC16 and SP-D in the control group were higher than those in the experimental group, but the sRAGE was less than the experimental group. Conclusions: Gastrointestinal surgery in elderly patients with pulmonary insufficiency, lung protective ventilation of low tidal volume, compared to conventional mechanical ventilation can reduce the severity of inflammation, better protect the airway function and blood gas status and safety of anesthesia.
高德鸿. 小潮气量肺保护性通气对老年合并肺功能不全胃肠手术患者术后转归的影响[J]. 河北医学, 2018, 24(2): 215-222.
GAO Dehong. Effect of Small Tidal Air Volume Lung Protective Ventilation on PostoperativeReintegration of Catients with Incomplete Gastroenteral Surgery for Elderly combined with Pulmonary Dysfunction. HeBei Med, 2018, 24(2): 215-222.
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2018, Vol. 24 
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