Clinical application of protective mechanical ventilation in thoracoscopic segmentectomy for lung cancer

doi:10.3877/cma.j.issn.1674-6902.2024.04.011

Abstract

Abstract:

Objective

To analyze the clinical effect of protective mechanical ventilation (PMV) in thoracoscopic segmentectomy for lung cancer.

Methods

A total of 68 patients with lung cancer who underwent thoracoscopic segmental resection in our hospital from January 2023 to January 2024 were selected as the subjects, 35 patients with conventional mechanical ventilation as the control group, and 33 patients with protective mechanical ventilation as the observation group. The intraoperative single lung ventilation platform pressure and peak airway pressure were compared between the two groups for 15 min and 60 min. It was compared that reoperative and postoperative arterial oxygen partial pressure (PaO₂), forced expiratory volume in first second (FEV₁), forced expiratory volume, FVC), maximal voluntary ventilation (MVV) per minute, compliance of dynamic (Cd) and compliance of static (Cs), malondialdehyde (MDA), superoxide dismutase (SOD) and life quality level.

Results

In the observation group, platform pressure single lung ventilation for 15min (16.00±3.00) cmH₂O, 60min(13.00±3.00) cmH₂O and airway peak single lung ventilation for 15 min (20.00±4.00) cmH₂O, 60 min(16.00±3.00) cmH₂O were lower than that of the control group 15 min (20.00±4.00) cmH₂O, 60min (19.00±2.00) cmH₂O, Airway peak pressure single lung ventilation for 15 min (27.00±4.00) cmH₂O and 60min (25.00±3.00)cmH₂O (P<0.05). PaO₂, FEV₁, FVC and MVV decreased in two groups after operation (P<0.05). Observation group PaO₂ (78.31±5.22)mmHg, FEV₁ (1.13±0.42)L, FVC (2.18±0.51)L and MVV (92.34±4.26)L were higher than PaO₂(61.23±6.27)mmHg, FEV₁ (0.96±0.51)L, FVC (2.02±0.32) L and MVV (90.17±3.45)L in the control group (P<0.05); The levels of Cd and Cs in the observation group were higher (41.00±5.00) and Cs (128.00±32.00) than those in the control group (38.00±5.00) and Cs (113±43) (P<0.05). SOD (74.32±6.57) U/ml in the observation group was higher than that in the control group (70.32±5.46) U/ml. The MDA (4.87±0.66) nmol/ml was lower than that of the control group (5.24±0.68) nmol/ml (P<0.05). The life quality score of the observation group was higher than that of the control group (P<0.05).

Conclusion

Protective mechanical ventilation in thoracoscopic segmental resection of lung cancer can effectively improve lung function, it has clinical significance.

Key words: Bronchial lung cancer, Protective mechanical ventilation, Thoracoscopic pneumonectomy, Lung function, Oxidative stress, Quality of life

Xuan Zhang, Yang Gao, Yajun Fang, Yanling Yao. Clinical application of protective mechanical ventilation in thoracoscopic segmentectomy for lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(04): 563-567.

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References 30

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组　别	例数	平台压(cmH₂O)		气道峰压(cmH₂O)
组　别	例数	单肺通气15 min	单肺通气60 min	单肺通气15 min	单肺通气60 min
观察组	33	16.00±3.00	13.00±3.00	20.00±4.00	16.00±3.00
对照组	35	20.00±4.00	19.00±2.00	27.00±4.00	25.00±3.00
t值		4.345	4.762	5.264	5.638
P值		0.038	0.034	0.030	0.027

组　别	例数	平台压(cmH₂O)		气道峰压(cmH₂O)
组　别	例数	单肺通气15 min	单肺通气60 min	单肺通气15 min	单肺通气60 min
观察组	33	16.00±3.00	13.00±3.00	20.00±4.00	16.00±3.00
对照组	35	20.00±4.00	19.00±2.00	27.00±4.00	25.00±3.00
t值		4.345	4.762	5.264	5.638
P值		0.038	0.034	0.030	0.027

组　别	例数	FEV₁(L)		FVC(L)		MVV(L)		PaO₂(mmHg)
组　别	例数	术前	术后3 h	术前	术后3 h	术前	术后3 h	术前	术后3 h
观察组	33	1.58±0.31	1.13±0.42	2.28±0.42	2.18±0.51	95.05±3.42	92.34±4.26	87.02±5.36	78.31±5.22
对照组	35	1.59±0.32	0.96±0.51	2.29±0.37	2.02±0.32	94.86±4.24	90.17±3.45	86.93±6.12	61.23±6.27
t值		0.476	4.387	0.482	2.836	0.486	4.251	0.532	5.632
P值		0.673	0.037	0.662	0.046	0.727	0.040	0.627	0.027

组　别	例数	FEV₁(L)		FVC(L)		MVV(L)		PaO₂(mmHg)
组　别	例数	术前	术后3 h	术前	术后3 h	术前	术后3 h	术前	术后3 h
观察组	33	1.58±0.31	1.13±0.42	2.28±0.42	2.18±0.51	95.05±3.42	92.34±4.26	87.02±5.36	78.31±5.22
对照组	35	1.59±0.32	0.96±0.51	2.29±0.37	2.02±0.32	94.86±4.24	90.17±3.45	86.93±6.12	61.23±6.27
t值		0.476	4.387	0.482	2.836	0.486	4.251	0.532	5.632
P值		0.673	0.037	0.662	0.046	0.727	0.040	0.627	0.027

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