帕瑞昔布钠联合持续气道正压通气对食管癌根治术患者肺内分流和氧合的影响

doi:10.3969/j.issn.1007-3205.2021.02.021

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (2): 218-221.doi: 10.3969/j.issn.1007-3205.2021.02.021

帕瑞昔布钠联合持续气道正压通气对食管癌根治术患者肺内分流和氧合的影响

1.海南省文昌市人民医院麻醉科，海南文昌 571300；2.海南省儋州市人民医院麻醉科，海南儋州 571700

出版日期:2021-02-25 发布日期:2021-03-09
作者简介:许环航（1971-），男，海南文昌人，海南省文昌市人民医院副主任医师，医学学士，从事临床麻醉学研究。

Effect of Praecoxib sodium combined with continuous positive airway pressure on pulmonary shunt and oxygenation in patients undergoing radical esophagectomy

1.Department of Anesthesiology, Wenchang People′s Hospital of Hainan Province, Wenchang
571300, China; 2.Department of Anesthesiology, Danzhou People′s Hospital of
Hainan Province, Danzhou 571700, China

Online:2021-02-25 Published:2021-03-09

摘要/Abstract

摘要： 目的观察帕瑞昔布钠联合持续气道正压通气对食管癌根治术患者肺内分流和氧合的影响，探讨帕瑞昔布钠对患者肺功能的保护作用。
方法选择接受胸腹腔镜下食管癌根治术的患者60例被随机分配到观察组和对照组，每组30例，观察组患者给予帕瑞昔布钠，对照组给予生理盐水，2组均采用持续气道正压通气。比较2组手术时间、单肺通气时间、拔管时间，于麻醉诱导前(指定为时间T1)、单肺通气30 min(T2)及恢复双肺通气30 min(T3)时分别测定对照和观察组患者的血氧分压、CO2分压，计算肺内分流率(Qs/Qt)。
结果 2组患者的手术时间、单肺通气时间及拔管时间的差异无统计学意义(P＞0.05)。2组在血氧分压方面呈现先降低后增高的趋势。在CO2分压、肺内分流率方面呈现先增高后降低的趋势。2组在血氧分压、肺内分流率方面组间、时点间、组间·时点间交互作用方面差异均有统计学意义（P＜0.05）,而CO2分压在组间、组间·时点间交互作用方面差异均有统计学意义（P＜0.05）。
结论食管癌根治术患者，帕瑞昔布钠联合持续气道正压通气可减少肺内分流，提高血氧分压，有助于防止低氧血症的发生。

关键词: 食管肿瘤, 帕瑞昔布钠, 连续气道正压通气

Abstract: Objective To observe the effect of Praecoxib sodium combined with continuous positive airway pressure(CPAP) on pulmonary shunt and oxygenation in patients with esophageal cancer undergoing radical resection, and to explore the protective effect of Praecoxib sodium on pulmonary function.
Methods A total of 60 patients undergoing thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer were randomly assigned to the observation group(n=30) and the control group(n=30). The observation group was given parecoxib sodium and the control group was given saline. Both groups were given CPAP. The duration of operation, duration of one-lung ventilation(OLV) and extubation time were compared between two groups. The PaO2 and PaCO2 were measured before induction of anesthesia(T1), 30 min after OLV(T2) and 30 min after recovery of two-lung ventilation(T3), and the intrapulmonary shunt rate(Qs/Qt) was calculated.
Results There was no significant difference in duration of operation, duration of OLV and extubation time between two groups(P＞0.05). The PaO2 decreased initially and increased afterwards in two groups. PCO2 and Qs/Qt showed a trend of initial increasing and then decreasing. The difference of interaction between groups, time points and time points between groups were statistically significant with respect to PaO2 and Qs/Qt. The difference of interaction between groups, and time points between groups were statistically significant in terms of PCO2(P＜0.05).
Conclusion For esophageal cancer patients undergoing radical resection, the combination of Parecoxib sodium and CPAP can reduce intrapulmonary shunt, improve PaO2, and help prevent the occurrence of hypoxemia.

Key words: esophageal neoplasms； Parecoxib sodium, continuous positive airway pressure

许环航, 王航. 帕瑞昔布钠联合持续气道正压通气对食管癌根治术患者肺内分流和氧合的影响[J]. 河北医科大学学报, 2021, 42(2): 218-221.

XU Huan-hang, WANG Hang. Effect of Praecoxib sodium combined with continuous positive airway pressure on pulmonary shunt and oxygenation in patients undergoing radical esophagectomy[J]. Journal of Hebei Medical University, 2021, 42(2): 218-221.

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帕瑞昔布钠联合持续气道正压通气对食管癌根治术患者肺内分流和氧合的影响

Effect of Praecoxib sodium combined with continuous positive airway pressure on pulmonary shunt and oxygenation in patients undergoing radical esophagectomy

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