[胸腔或上腹部手术后患者的呼吸功能]。

K Mahkovic-Hergouth, L Tos, B Stangl
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引用次数: 0

摘要

研究对象为上腹部或胸部手术后第一个小时的患者。我们考虑患者术后第一个小时的呼吸功能,以及当时全麻残留对呼吸功能的影响。术后SaO2值下降有统计学意义,多例患者术后出现低氧血症。我们发现两组患者术后第一个小时的分钟通气量减少。无论如何,在静脉麻醉后恢复的腹部组患者中,分钟通气量更少。腹部组患者的良心恢复速度也较慢。在手术的前30分钟,腹部病人出现术中放松后的肌肉无力。但在手术后的前半小时,他们有满意的镇痛效果。相反,胸侧组患者术后疼痛更严重。胸侧组患者术后气体交换更频繁、更严重,且多为既往肺部疾病患者,通气/灌注失衡更严重,右向左分流更严重。腹部组只有静脉麻醉时间较短的患者在术后1小时内出现低氧血症。我们认为,这些患者术后立即出现的气体交换异常也是由全身麻醉后的低通气引起的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Respiratory function in patients immediately after surgery of the thorax or upper abdomen].

The study deals with the patients in the first postoperative hour following the operation in the upper abdomen or thorax. We considered the respiratory function of the patients in the first postoperative hour and how the respiratory function is influenced by the residua of general anesthesia at that time. Statistically significant decrease of postoperative SaO2 values was found and many patients were hypoxemic after the operation. We found decreased minute ventilation in the first postoperative hour in both groups of patients. Anyway the minute ventilation was more decreased in the abdominal group of patients who recovered from intravenous anesthesia. The conscience as well was more slowly returned to the patients in the abdominal group. In the first 30 minutes more abdominal patients suffered from the muscular weakness following intraoperative relaxation. But this first half an hour after the operation they had satisfactory level of analgesia left. To the contrary the postoperative pain was more severe in the thoracal group of patients. Postoperative gas exchange was more often and more seriously disturbed in the thoracal group of patients who in majority suffered from previous lung disease, which means they had greater ventilation/perfusion imbalance and greater right to left shunt. In the abdominal group only the patients who had relatively short intravenous anesthesia were found hypoxemic in the first postoperative hour. We think that in these patients the gas exchange abnormalities immediately after the operation are also caused by the hypoventilation which often follows general anesthesia.

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