ĐÁNH GIÁ SỰ THAY ĐỔI MỘT SỐ THÔNG SỐ CƠ HỌC PHỔI TRƯỚC VÀ SAU HUY ĐỘNG PHẾ NANG TRONG PHẪU THUẬT NỘI SOI Ổ BỤNG

Abstract

Objective: To evaluate changes in certain pulmonary mechanical parameters before and after alveolar recruitment in laparoscopic abdominal surgery. Subjects and Methods: A total of 41 patients indicated for laparoscopic abdominal surgery under general anesthesia with endotracheal intubation at the 108 Military Central Hospital, from October 2023 to May 2024. Results: The average age was 63.59 ± 11.35 years; the average BMI was 22.28 ± 1.39; the male-to-female ratio was 2.2:1; ASA classification I: 46.3%, ASA classification II: 53.7%; 36.6% underwent upper abdominal surgery, while 65.4% had lower abdominal surgery; the average anesthesia duration was 173.05 ± 18.36 minutes, and the average surgery duration was 143.90 ± 17.41 minutes. Pulmonary compliance after abdominal insufflation (32.83 ± 9.51) was lower than after endotracheal intubation (53.49 ± 14.63) (p<0.05). Pulmonary compliance before alveolar recruitment was lower than after recruitment, respectively: first recruitment: 31.66 ± 8.94 vs. 36.00 ± 10.18; second recruitment: 42.85 ± 13.25 vs. 50.22 ± 17.70 (p<0.05). Ppeak and Pmean after abdominal insufflation (21.29 ± 2.93; 11.2 ± 1.06) were higher than after intubation (16.07 ± 2.19; 9.22 ± 0.85) (p<0.05). There was no statistically significant difference in Ppeak and Pmean before and after alveolar recruitment (p<0.05). Conclusion: Alveolar recruitment increases lung compliance without altering airway pressure.