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目的探讨猪供肺获取手术的技术训练方法与评估指标。方法总结15只猪供肺获取手术的手术技巧,评估手术时间、灌注前的客观评价指标、灌注后的大体观、术中操作失误及频率等。结果 15只猪供肺获取手术均顺利完成。从切皮到肺灌洗开始平均时间为22.6 min。灌注前供肺的氧合指数为(501±68)mm Hg,潮气量为(404±100)mL(15 mm Hg压力支持下),静止顺应性为(29±4)mL/cm H_2O,随着操作次数增加,氧合指数和潮气量有所改善。供肺灌注后大部分肺膨胀良好。手术出现多种操作失误,包括解剖操作性失误、肺动脉插管相关失误、步骤性失误等,随着操作次数增加,失误频率明显减少。结论经过一定量的猪肺获取手术的训练,术中步骤性失误明显减少,肺质量也会有改善趋势。氧合指数等客观指标和供肺大体观可评估手术技术水平。
Objective To explore the technical training method and evaluation index of lung-harvesting in pigs. Methods The operation skills of 15 pigs for pulmonary operation were summarized, and the operation time, the objective evaluation index before perfusion, the gross view after perfusion, the operation errors and the frequency of operation were evaluated. Results All the 15 pigs received pulmonary surgery successfully. The average time from incision to lung lavage was 22.6 min. The oxygenation index for lungs before perfusion was (501 ± 68) mm Hg, the tidal volume was (404 ± 100) mL (15 mm Hg) and the resting compliance was (29 ± 4) mL / cm H 2 O With the increase in the number of operations, oxygenation index and tidal volume have been improved. Most lungs are well inflated after lung perfusion. A variety of operational errors occurred in the operation, including anatomical operational errors, pulmonary arterial intubation related errors, procedural errors, with the increase in the number of operations, the error frequency significantly reduced. Conclusion After a certain amount of lung harvesting operation training, procedural errors were significantly reduced, the lung quality will also improve. Oxygenation index and other objective indicators and for the general concept of pulmonary surgery can be assessed technical level.