呼气末正压通气递增法肺复张用于胸腔镜肺切除术全麻患者中的效果

doi:10.3969/j.issn.1671-7171.2025.04.017

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Abstract 【Objective】 This study aims to explore the effectiveness of lung recruitment using the incremental positive end-expiratory pressure (PEEP) in patients undergoing thoracoscopic lung resection under general anesthesia. 【Methods】 Seventy-eight lung cancer patients were randomly divided into an observation group and a control group, with 39 patients in each group. All patients underwent thoracoscopic lung resection under general anesthesia. The control group received controlled lung expansion for lung recruitment, whereas the observation group used the PEEP incremental method. The comparison between the two groups were based on lung atelectasis score (LUS), oxygenation index (OI), dynamic lung compliance (Cdyn), mean arterial pressure (MAP), and lung function indicators [vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), FEV₁/FVC and maximum voluntary ventilation (MVV)], along with the incidence of complications. 【Results】 After lung recruitment, there was no significant statistical difference in OI, Cdyn, and MAP in the observation group compared to before recruitment (P>0.05). In contrast, these measures after lung recruitment significantly decreased in the control group (P<0.05). After recruitment, the levels of OI, Cdyn, and MAP in the observation group were higher than those in the control group (P<0.05). The LUS scores of both groups at the end of the surgery (T₁) were significantly lower than those at one minute after the induction of mechanical ventilation (T₀) and further decreased 30 minutes after entering the anesthesia recovery room (T₂) (P<0.05), with the observation group showing lower LUS scores at T₁ and T₂ than the control group (P<0.05). Postoperatively, VC, FVC, FEV₁, FEV₁/FVC, and MVV decreased in both groups compared to preoperative levels (P<0.05), with the observation group having higher values than the control group (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). 【Conclusion】 The PEEP incremental method in thoracoscopic lung resection under general anesthesia can more rapidly restore OI, Cdyn, and MAP, increase lung aeration, speed up lung function recovery, and result in fewer postoperative complications. It is worthy of clinical promotion and application.

Key words： Thoracoscopy Pneumonectomy Pulmonary Atelectasis Anesthesia General

Received: 20 January 2023

PACS:

R655.3

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	YIN Tianying
	JIN Man

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YIN Tianying,JIN Man. Observation of the Effect of Incremental Positive End-Expiratory Pressure Ventilation for Lung Recruitment in Patients Undergoing Thoracoscopic Lung Resection under General Anesthesia[J]. JOURNAL OF CLINICAL RESEARCH, 2025, 42(4): 619-622.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.04.017 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I4/619

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