沙丁胺醇对慢性阻塞性肺疾病患者单肺通气时肺萎陷的影响

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (1): 88-91.

沙丁胺醇对慢性阻塞性肺疾病患者单肺通气时肺萎陷的影响

周其富¹, 蒋宗明¹, 王海勇²

¹浙江省绍兴市人民医院麻醉科
²胸外科,绍兴 312000,浙江

收稿日期:2011-10-07 修回日期:2011-11-10 出版日期:2012-01-26 发布日期:2012-02-16
作者简介:周其富,男,学士,副主任医师,研究方向:临床麻醉与体外循环灌注学。Tel: 13173983055 E-mail: zqf197611@126.com

Effects of Salbutamol on lung collapse during one-lung ventilation in patients with chronic obstructive pulmonary disease

ZHOU Qi-fu¹, JIANG Zong- ming¹, WANG Hai-yong²

¹Department of Anesthesiology
²Department of Thoracic Surgery, Zhejiang Shaoxing People's Hospital, Shaoxing 312000, Zhejiang,China

Received:2011-10-07 Revised:2011-11-10 Online:2012-01-26 Published:2012-02-16

摘要/Abstract

摘要： 目的: 麻醉诱导前吸入硫酸沙丁胺醇气雾剂(万托林), 观察其对慢性阻塞性肺疾病(COPD)患者单肺通气期间的肺萎陷的影响。方法: 合并慢性阻塞性肺疾病的拟行肺叶切除手术的患者40例,随机分成观察组和对照组各20例,观察组:患者给予万托林200 μg(2揿)后面罩吸氧; 对照组:单纯面罩吸氧,30 min后开始麻醉诱导。单肺通气开始后10和20 min的时间点用口头量表评价肺萎陷的程度。记录基础、麻醉诱导前、双肺通气以及单肺通气后的30 min内每10 min的血气分析。结果: 观察组肺萎陷评分优于对照组(P<0.05);麻醉诱导前、双肺通气、单肺通气10 min及20 min的PaCO₂值观察组低于对照组,观察组PaO₂值高于对照组(P<0.05 or P<0.01)。结论: 硫酸沙丁胺醇气雾剂能加速慢性阻塞性肺疾病患者单肺通气早期肺萎陷的过程,改善单肺通气时的手术条件。

关键词: 沙丁胺醇, 阻塞性肺疾病, 单肺通气, 肺萎陷

Abstract: AIM: To study the effects of Salbutamol aerosol inhalation prior to anesthesia induction on lung collapse during one lung ventilation in patients with chronic obstructive pulmonary disease.METHODS: Fourty patients with concomitant chronic obstructive pulmonary disease, scheduled for lobectomy were randomly allocated into observation group(n=20) and control group(n=20) . Salbutamol aerosol 200 μg (two puffs) were administered according to instructions before oxygenation via mask in observation group, whereas in control group no aerosol was given before oxygenation via mask. Anesthesia induction was initiated after 30 minutes' oxygenation in both groups. Extent of lung collapse was evaluated by verbal scale in 10 minutes and 20 minutes after one lung ventilation. Blood gas analysis was assayed in baseline, before anesthesia induction, double lung ventilation and 30 minutes during one lung ventilation(every 10 minutes was performed).RESULTS: There was statistical significance in lung collapse score between observation group and control group(P<0.05), the former was superior to the latter.Compared with the control group, the value of PaCO₂ in anesthesia induction, double lung ventilation, 10 minutes and 20 minutes after one lung ventilation were lower than that in observation group, however , the value of PaO₂ were higher in respective time.CONCLUSION: Salbutamol aerosol inhalation can accelerate lung collapse in early stage of one lung ventilation and at the same time provide better surgical access condition in patients with chronic obstructive pulmonary disease.

Key words: Salbutamol, Chronic obstructive pulmonary disease, One-lung ventilation, Lung collapse

中图分类号:

R974

周其富, 蒋宗明, 王海勇. 沙丁胺醇对慢性阻塞性肺疾病患者单肺通气时肺萎陷的影响[J]. 中国临床药理学与治疗学, 2012, 17(1): 88-91.

ZHOU Qi-fu, JIANG Zong- ming, WANG Hai-yong. Effects of Salbutamol on lung collapse during one-lung ventilation in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(1): 88-91.

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