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目的 观察七氟醚复合异丙酚麻醉在胸外科手术行单肺通气期间对肺内分流和血气的影响.方法 30例ASAⅠ～Ⅱ级的患者,用芬太尼4～5 μg/kg,咪唑安定0.05 mg/kg,异丙酚1.5～2 mg/kg,维库溴铵0.1 mg/kg作静脉快速诱导,插入双腔气管导管.用丙泊酚每千克体重6～8 mg/h泵注,吸入1.3～2.5 MAC的七氟醚,间断静脉滴注维库溴铵和芬太尼维持麻醉.分别在单肺通气前1 min(T1)、单肺通气15 min(T2)、30 min(T3)及单肺通气结束前1 min(T4)各时刻抽取动脉血和混合静脉血行血气分析,并根据血气分析结果计算肺内分流率(Qs/Qt).结果 T2、T3、T4时刻,肺内分流率较T1时刻显著增加,动脉血氧分压较T1时刻显著下降, T4时刻的动脉血氧分压较T3时刻有所回升.结论 单肺通气时七氟醚复合异丙酚静吸麻醉虽然对肺内分流有影响,但不影响其在临床中安全应用.“,”Objective To evaluate the effects of sevoflurane combined with propofol for one lung ventilation(OLV) on intrapulmonary shunt(Qs/Qt) and blood gas. Methods Thirty ASAⅠ-Ⅱpatients were selected in the study. Anesthesia was induced with midazolam 0.05 mg/kg,fentanyl 4-5 μg/kg,propofol(1.5-2)mg/kg,and vecuronium 0.1 mg/kg,and double-lumen endotracheal tubes were intubated.Anesthesia was maintained with 1.3-2.5 MAC sevoflurane inhalation, propofol 6-8 mg/h and intermittent iv boluses of vecuronium and fentanyl arterial blood and mixed venous blood were taken for blood gas analysis 1 minute before OLV(T1),15 minutes after OLV(T2), 30 minutes after OLV(T3),and 1 minute before OLV(T3) was over. Qs/Qt was calculated.Results Intrapulmonary shunt (Qs/Qt) increased significantly and PaO2 decreased significantly at T2, T3and T4 compared with those at T1(P<0.01),and PaO2 increased significantly at T4 compared with those at T3(P<0.05).Conclusion During the OLV sevoflurane inhalation combined with propofol has influences on intrapulmonary shunt, but can be safely used clinically.