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目的讨论大容量全肺灌洗术(whole lung large WLL)术中低氧血症的临床原因。方法对35例WLL术中低氧血症患者和未发生低氧血症患者35例进行尘肺期别、体重、术前有无基础病、术前血气分析、术前肺功能、术中气道压、灌洗液残余量进行分析。结果 35例低氧血症患者,超重、术前肺功能异常、术前血气PO2<70 mm Hg、术中气道压高、灌洗液残余量大、支气管痉挛者明显高于对照组。结论 WLL术中低氧血症的发生与超重、术前肺功能异常、术前血气PaO2<70mm Hg、术中气道压高、灌洗液残余量大和支气管痉挛等因素有关。
Objective To discuss the clinical causes of hypoxemia during whole lung large WLL surgery. Methods Thirty-five patients with hypoxemia and 35 patients without hypoxemia were studied for pneumoconiosis, body weight, preoperative absence of underlying disease, preoperative blood gas analysis, preoperative pulmonary function, intraoperative airway Pressure, the amount of lavage fluid analysis. Results 35 cases of hypoxemia patients, overweight, preoperative pulmonary dysfunction, preoperative blood gas PO2 <70 mm Hg, intraoperative airway pressure, large amount of residual lavage fluid, bronchospasm were significantly higher than the control group. Conclusion The incidence of hypoxemia in WLL is related to overweight, preoperative pulmonary dysfunction, preoperative PaO2 <70mm Hg, high intraoperative airway pressure, large amount of lavage fluid residue and bronchospasm.