Impact of Pressure-Controlled Volume-Guaranteed Ventilation on Pulmonary Function in Coal Workers with Pneumoconiosis Undergoing Laparoscopic Cholecystectomy.
Junfeng Zhang, Bin Li, Jiangbo Qu, Yanan Li, Jiahui Liu, Huibin Mao
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引用次数: 0
Abstract
Objective: This study aimed to investigate the effects of the pressure-controlled volume-guaranteed ventilation (PCV-VG) mode on pulmonary function in patients with pneumoconiosis undergoing laparoscopic cholecystectomy.
Methods: Forty patients with pneumoconiosis scheduled for elective laparoscopic cholecystectomy under general anesthesia were randomly divided into two groups using a random number table method: the PCV-VG mode group and the volume-controlled ventilation (VCV) mode group. The primary outcome was lung ultrasound score (LUS) after entering the operating room (T0), at the end of surgery (T3), 30 minutes after tracheal extubation (T4), and 2 hours postoperatively (T5). Peak airway pressure (Ppeak) and plateau pressure (Pplat) were recorded 2 minutes before (T1) and 20 minutes after the initiation of artificial pneumoperitoneum (T2). Arterial blood gas analyses were performed at T0, T2, and T4 to calculate the oxygenation index (OI).
Results: Compared to the VCV group (n = 20), the PCV-VG group (n = 20) exhibited significantly improvement of median LUS at T3, T4, and T5 (all P < .05). Significantly lower Ppeak and Pplat were found in PCV-VG group at T1 (16.2 ± 1.81 and 14.6 ± 1.85) and T2 (24.3 ± 2.75 and 19.7 ± 3.08) (P < .05). Additionally, median OI significantly improved at T2 and T4 in PCV-VG group (P < .05). No early postoperative pulmonary complications were found in both groups.
Conclusion: For patients with pneumoconiosis undergoing laparoscopic cholecystectomy, the PCV-VG mode can reduce intraoperative airway pressures and early postoperative LUS values, decrease ventilation loss, and improve perioperative oxygenation.
目的：探讨压力控制容积保证通气（PCV-VG）模式对尘肺患者腹腔镜胆囊切除术后肺功能的影响。方法：选取40例全麻下择期腹腔镜胆囊切除术尘肺患者，采用随机数字表法随机分为PCV-VG模式组和VCV模式组。主要观察指标为入手术室后（T0）、手术结束时（T3）、拔管后30分钟（T4）、术后2小时（T5）肺超声评分（LUS）。记录人工气腹开始前2分钟（T1）和开始后20分钟（T2）气道峰值压力（Ppeak）和平台压力（Pplat）。在T0、T2和T4进行动脉血气分析，计算氧合指数（OI）。结果：与VCV组（n = 20）相比，PCV-VG组（n = 20）在T3、T4、T5时的中位LUS均有显著改善（均P P P P）。结论：对于腹腔镜胆囊切除术尘肺患者，PCV-VG模式可降低术中气道压力和术后早期LUS值，减少通气损失，改善围手术期氧合。
期刊介绍：
JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons publishes original scientific articles on basic science and technical topics in all the fields involved with laparoscopic, robotic, and minimally invasive surgery. CRSLS, MIS Case Reports from SLS is dedicated to the publication of Case Reports in the field of minimally invasive surgery. The journals seek to advance our understandings and practice of minimally invasive, image-guided surgery by providing a forum for all relevant disciplines and by promoting the exchange of information and ideas across specialties.
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