Effects of Different Inhalation Oxygen Concentrations Combined with PCV-VG Mode on Oxygenation and Lung Injury in Elderly Patients with Laparoscopic Bladder Cancer
Objective:To investigate the effects of different inhalation oxygen concentrations combined with pressure-controlled volume-assured ventilation mode(PCV-VG)on oxygenation and lung injury in elderly patients with laparoscopic bladder cancer.Methods:90 elderly patients with bladder cancer who planned to undergo laparoscopic radical surgery for bladder cancer under general anesthesia in our hospital from March 2022 to March 2023 were selected as research objects and randomly divided into group A,group B and group C,with 30 cases in each group.All patients maintained mechanical ventilation in PCV-VG mode,and the inhaled oxygen concentrations in groups A,B,and C were 40％,50％,and 60％,respectively.Heart rate(HR),mean arterial pressure(MAP),right atrial pressure(RAP)and partial arterial oxygen pressure(PaO2)were detected before ventilation(T0),1 h,2 h and 3 h after ventilation(T1-3)and 0.5 h after catheter removal(T4).Oxygenation index(PaO2/FiO2)and respiratory index(RI)were calculated.Clinical pulmonary infection score(CPIS),residence time of PACU and postoperative hospital stay were recorded 24 hours after surgery.The expression levels of serum pul-monary surface active protein A(SP-A)and Clara cell secreted protein(CC 16)before and after surgery and the incidence of postoperative pulmonary complications were compared among the three groups.Results:There was no difference in HR,MAP and RAP among the three groups at T0,T1,T2,T3 and T4(P＞0.05).At T1,T2,T3 and T4,PaO2 and PaO2/FiO2 in group A were lower than those in group B and C,and RI was higher than those in group B and C(P＜0.05).There were no significant differences in PaO2,PaO2/FiO2 and RI between group B and group C at each time point(P＞0.05).There was no significant difference in PACU residence time among the three groups(P＞0.05).The postoperative CPIS score of group B was lower than that of group A and C,and the postoperative hospitalization time was shorter than that of group A and C(P＜0.05).The expression levels of SP-A and CC16 in group B were lower than those in group A and group C(P＜0.05).The incidence of postoperative pulmonary complications in group B was lower than that in group A and group C(P＜0.05).Conclusion:50％ inhalation oxygen concentration combined with PCV-VG mode can effectively improve the oxygenation function and reduce lung injury in elderly patients with laparoscopic bladder cancer,and has a positive effect on reducing postoperative complica-tions and promoting rehabilitation,which is worthy of clinical attention.
万方数据
维普
