目的探讨压力控制-容量保证通气(pressure-controlled ventilation-volume guaranteed,PCV-VG模式与容量控制通气(volume-controlled ventilation,VCV)模式对胸腔镜肺切除术患者术后肺部并发症的影响。方法回顾性分析2020年9月—2021年3月在四川大学华西医院行择期胸腔镜肺手术329例患者的临床资料,其中女213例、男116例,平均年龄(53.6±11.3)岁。美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ~Ⅲ级。纳入患者麻醉期间均采用肺保护性通气策略,根据通气模式将其分为PCV-VG组(PCVVG模式,165例)和VCV组(VCV模式,164例)。主要结局指标为住院期间肺部并发症发生率。结果术后住院期间共有73例(22.2%)患者发生了肺部并发症,PCV-VG组发生率为21.8%,VCV组发生率为22.6%[RR=0.985,95%CI(0.569,1.611),P=0.871]。多因素logistic回归分析显示PCV-VG与VCV模式相比,住院期间术后肺部并发症发生率差异无统计学意义[OR=0.846,95%CI(0.487,1.470),P=0.553]。结论对于胸腔镜肺手术患者,通气模式的选择与住院期间术后肺部并发症的发生风险不相关。
OBJECTIVE: To investigate the role of adrenomedullin (AM) in the development of hypoxic pulmonary hypertension (HPH), and to assess the expression of AM and adrenomedullin receptor (AMR) in the lungs of rats with HPH. METHODS: We exposed 10 rats to normobaric hypoxic conditions for 3 weeks to establish rat model of pulmonary hypertension; and 10 other rats were used as normoxic controls. Mean pulmonary arterial pressure (mPAP) was measured by a right cardiac catheterization. The thickness of pulmonary arterioles was measured by a computerized image analyzer. We used the reverse transcription-polymerase chain reaction (RT-PCR) to assess the change of expression of AM and AMR in lung of HPH rat model. RESULTS: Compared with the control group, hypoxic rats developed remarkable pulmonary hypertension, increment in the thickness of pulmonary arterioles and right ventricular hypertrophy (P
