Effects Of Pressure-controlled Volume Guaranteed Ventilation On Perioperative Period In Patients With Single-lung Ventilation

Objective:With open thoracic surgery and Single-Lung Ventilation in patients with line as the research object,through the observation of different ventilation modes on hemodynamics in patients with lung function,lung inflammation medium to express,differences in the influence of related indicators,assessment of different ventilation mode after open heart surgery,the differences in the application effect of Single-Lung Ventilation,airway pressure control,capacity evaluation to ensure ventilation mode?Pressure Controlled Ventilation Volume-Guaranteed,PCV-VG?is feasible,in order to optimize intraoperative ventilation mode,stable patients with respiratory dynamics and protective lung ventilation function.Methods:From March 2018 to March 2019,90 patients who received thoracotomy surgery in the hospital and needed to undergo Single-Lung Ventilation were selected as the study objects.All patients were mechanically ventilated with anesthesia machines during the operation.Patients were divided into the PCV-VG group and the traditional PCV group according to the ventilation mode.Each group had 45 patients,and the PCV-VG group accepted the PCV-VG ventilation mode?the pressure was set as 6ml/kg tidal volume pressure value,f=15times/min,the suction:breath ratio was1:2,and the maximum pressure of the inspiratory phase airway platform was set as25cmH₂O?.Conventional PCV group using traditional PCV ventilation mode?pressure setting for up to 6ml/kg tidal volume pressure value,f=15times/min,suck:call ratio of 1:2?.The hemodynamics,respiratory dynamics,inflammatory mediators and pulmonary function related indicatorsof the two groups were measured at each time point before Single-Lung Ventilation?T₀?,one hour after Single-Lung Ventilation?T₁?,two hours after Single-Lung Ventilation?T₂?,and three hours?T₃?.And use of SPSS.19.0 statistical software for statistical analysis.Results:1.Comparison of hemodynamic indexes between groups:when comparing HR and MAP between groups at T0,P>0.05,and the difference was not statistically significant.After Single-Lung Ventilation,HR and MAP levels in the traditional PCV group were compared with those in the T₀ group,P<0.05,indicating a statistically significant difference;while those in the PCV-VG group were compared with those in the T₀ group,P<0.05,indicating a statistically significant difference.When comparing HR in the PCV-VG group with that in the T₀ group,P>0.05 was not statistically significant;when comparing HR and MAP in the PCV-VG group with that in the traditional PCV group at T₁,T₂ and T₃,P<0.05 was statistically significant.2.Comparison of respiratory mechanical indexes between groups:P_peak,P_mean,PaO₂and PaCO2 were compared between groups at T0,P>0.05,and the difference was not statistically significant.After Single-Lung Ventilation,PaCO2 and MAP of the two groups showed no significant change,P>0.05,and the difference was not statistically significant.When compared with T₀ in P_peakeak group after Single-Lung Ventilation,P>0.05 in PCV-VG group,and the difference was not statistically significant.At T1,T₂,and T₃,P_peak,P_mean,and PaO₂ in the PCV-VG group were higher than those in the traditional PCV group,P<0.05,indicating a statistically significant difference.3.Comparison of inflammatory mediators between groups:when compared with IL-6,IL-8,IL-1 beta and ICAM-1 between groups at T0,P>0.05 showed no statistically significant difference;After Single-Lung Ventilation,IL-6,IL-8,IL-1 beta and ICAM-1 in the two groups were significantly increased,and P<0.05 compared with T0 in the group,indicating a statistically significant difference.At T1,T2,and T3,IL-6,IL-8,IL-1 beta,and ICAM-1 in the PCV-VG group were significantly lower than those in the traditional PCV group,P<0.05,and the difference was statistically significant.4.Comparison of lung function indicators between groups:when D₀ was used,FVC,FEV₁ and MMEF were compared between groups,P>0.05,and the diff erence was not statistically significant.After Single-Lung Ventilation,FVC,FE V₁ rate and MMEF in the two groups were significantly decreased,P<0.05 co mpared with T0 in the group,and the difference was statistically significant.At D1,D2,FVC,FEV1 rate and MMEF in the PCV-VG group were significantl y higher than those in the traditional PCV group,P<0.05,and the difference was statistically significant.5.Comparison of complications between groups:the incidence of complications in the traditional PCV group was 44.44%,and the incidence of complications in the PCV-VG group was 22.22%,P<0.05,and the difference was statistically significant.6.Comparison of postoperative rehabilitation time between groups:the postoperative drainage tube removal time?9.44±2.07?d and postoperative hospitalization time?11.72±1.86?d of the PCV-VG group were lower than those of the traditional PCV group,P<0.05,and the difference was statistically significant.Conclusion:1.PCV-VG mode during Single-Lung Ventilation has less impact on heart rate and blood pressure and is more conducive to hemodynamic stability;2.During Single-Lung Ventilation,PCV-VG mode has more stable changes in respiratory mechanics and less impact on lung function,which is conducive to protecting lung function;3.PCV-VG mode during Single-Lung Ventilation can reduce inflammatory response,help prevent postoperative complications,and provide higher anesthesia safety;4.PCV-VG mode is conducive to promoting postoperative rehabilitation after thoracotomy and shortening hospitalization time.