Application of protective lung ventilation model in thoracic surgery patients with single lung ventilation / 中国医师杂志

ABSTRACT

Objective To explore the value of protective lung ventilation mode in patients undergoing single lung ventilation in thoracic surgery operation.Methods 59 patients undergoing surgical treatment in Ankang Central Hospital from January 2012 to January 2015 were analyzed.According to the ventilation mode adopted in the operation,the patients were divided into the protective group (30 cases) and conventional group (29 cases).The protective group took tidal volume 8 ml/kg.According to the patient's circulatory function,we gradually increase the end expiratory positive pressure ventilation,until 10 cmH2O.The conventional group took tidal volume 8 ml/kg and was maintained positive end expiratory pressure at 3 cmH2O.Results There was no statistically significant difference in operation time,blood volume,infusion volume,and single lung ventilation time between the protective group and the conventional group (P ＞ 0.05).There was also no statistically significant difference in T1,T2,T3,T4,inhalation of oxygen partial pressure (FiO2),mean arterial pressure (MAP) level between the two groups (P ＞ 0.05).The T2 and T3 moment of arterial oxygen partial pressure (PaO2) oxygenation index (OI) level in protective group was significantly higher than that in conventional group (P ＜ 0.05).The preoperative serum tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8),superoxide dismutase (SOD),macrophage inflammatory protein Ⅰ (MIP-Ⅰ),malondialdehyde (MDA) level between the two group showed no significant difference (P ＞0.05).While after the operation,the serum TNF-alpha,MIP-Ⅰ,IL-8 and the level of MDA in protective group was significantly lower than that of conventional group (P ＜ 0.05),the SOD level showed the opposite (P ＜ 0.05).Conclusions The protective lung ventilation mode is beneficial to maintain the blood gas indexes,at the same time reduce the inflammatory response and protect the lung function of the patients.