容量及压力控制通气模式对俯卧位腰椎融合术患者血流动力学的影响

摘要

Objective To compare the hemodynamic effect of volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) in patients undergoing lumbar spine fusion surgery in prone position.Methods Thirty-seven patients schedaled for posterior lumbar spine surgery were divided to V CV group (n=19) and PCV group (n=18) according to the different mechanical ventilation modes.The respiratory and hemodynamic variables from 10 minutes after prone position till 120 minutes (Tprone10,Tprone20,…,Tprone120) were recorded and compared.Results When the patient was in prone position,the mean arterial pressure in PCV group was higher than that in VCV group [(82.21±2.28) mmHg vs (75.72±2.04) mmHg,P＜0.05].With the same tidal volume,the dynamic compliance and peak airway pressure in PCV group were higher than those in VCV group (P＜0.05).Conclusion With better respiratory mechanic and hemodynamic stability,PCV is superior to VCV as a mechanical ventilation mode for lumbar spine surgery in prone position.%目的:探讨容量控制通气模式(VCV)和压力控制通气模式(PCV)对俯卧位腰椎融合术患者血流动力学的影响.方法:择期行后入路腰椎融合术患者根据不同通气模式随机分为两组,分别为VCV组(n=19)及PCV组(n=18).记录俯卧位后每10 min至120 min(Tprone10,Tprone20,…,Tprone120)的血流动力学及呼吸力学指标.结果:俯卧位时PCV组的平均动脉压高于VCV组[(82.21±2.28) mmHg vs(75.72±2.04) mmHg] (P＜0.05),同样潮气量下,PCV组的气道峰压及肺顺应性优于VCV组(P.＜0.05).结论:俯卧位腰椎手术中PCV对呼吸及循环系统干扰相对较小,更有利于术中血压的维持.