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目的:探讨轻、中度慢性阻塞性肺疾病(COPD)患者腹部手术采用七氟烷吸入麻醉的临床效果。方法:回顾性分析2016年6月至2018年6月义乌市中心医院行腹部手术的COPD患者68例的临床资料，根据1秒用力呼气容积占预测值比重(FEVn 1%pre)分为轻度组(FEVn 1%pre≥80%，n n＝39)与中度组(80%>FEVn 1%pre≥50%，n n＝29)。比较两组入室后(T0)、完成诱导后(T1)、腹腔探查时(T2)、术毕前(T3)、拔管后(T4)两组血气指标[动脉血氧分压(PaOn 2)、动脉血二氧化碳分压(PaCOn 2)、血氧饱和度(SaOn 2)]、生命体征[心率(HR)、平均动脉压(MAP)]、外周血管阻力(SVR)变化，分析两组苏醒质量指标差异。n 结果:T1、T2、T3时轻度组的PaOn 2分别为(301.6±76.2)mmHg、(292.6±73.4)mmHg、(112.8±34.1)mmHg，SaOn 2分别为(99.1±0.8)%、(98.8±1.0)%、(94.5±2.2)%，均较T0时均显著升高(n t＝23.51、22.73、12.34，2.75、2.93、2.22，均n P0.05)。T1、T2时，轻度组MAP分别为(75.5±11.0)mmHg、(80.7±11.9)mmHg，HR分别为(71.4±12.5)次/min、(74.2±13.6)次/min，SVR分别为(9.1±1.6)×10n 2 dynes·sn －1·cmn －5、(9.9±2.0)×10n 2 dynes·sn －1·cmn －5，均较T0时显著下降(n t＝1.35、0.95，1.83、0.64，1.42、0.27，均n P0.05)。T3、T4时，两组MAP、HR、SVR水平较T0时无明显变化，且组间同期比较，差异均无统计学意义(均n P>0.05)。轻度组自主呼吸时间、呼之睁眼时间、呼之握拳时间、拔除气管导管时间、送返病房时间均略短于中度组，但组间差异均无统计学意义(均n P>0.05)。n 结论:七氟烷吸入麻醉用于COPD患者腹部手术，造成血气指标变化趋势并不受COPD病情影响，可为临床确立麻醉方案提供参考。“,”Objective:To explore the clinical effects of general anesthesia of sevoflurane inhalation in abdominal surgery for patients with mild-to-moderate chronic obstructive pulmonary disease (COPD).Methods:The clinical data of 68 patients with COPD abdominal surgery who admitted to the Department of Anesthesiology of Yiwu Central Hospital from June 2016 to June 2018 were retrospectively analyzed.According to the ratio of forced expiratory volume in 1 second in predicted value (FEVn 1%pre), the patients were divided into mild group (FEVn 1%pre≥80%, n n=39) and moderate group (80%>FEVn 1%pre≥50%, n n=29). The blood gas indicators[arterial partial pressure of oxygen (PaOn 2), arterial partial pressure of blood carbon dioxide (PaCOn 2), blood oxygen saturation (SaOn 2)], vital signs[heart rate (HR), mean arterial pressure (MAP)] and systemic vascular resistance (SVR) were compared between the two groups after entering (T0), after completion of induction (T1), at abdominal exploration (T2), before the end of surgery (T3) and after extubation (T4). The recovery quality indicators were analyzed in the two groups.n Results:In the mild group at T1, T2 and T3, the PaOn 2 values were (301.6±76.2)mmHg, (292.6±73.4)mmHg, (112.8±34.1)mmHg, respectively, and the SaOn 2 values were (99.1±0.8)%, (98.8±1.0)%, (94.5±2.2)%, respectively, all of which were significantly improved compared with those at T0 (n t=23.51, 22.73, 12.34, 2.75, 2.93, 2.22, all n P0.05). At T1 and T2, the MAP levels in the mild group were (75.5±11.0)mmHg, (80.7±11.9)mmHg, respectively, the HR values were (71.4±12.5)times/min, (74.2±13.6)times/min, respectively, the SVR values were (9.1±1.6)×10n 2 dynesosn -1ocmn -5, (9.9±2.0) ×10n 2 dynesosn -1ocmn -5, which were significantly lower than those at T0 (n t=1.35, 0.95, 1.83, 0.64, 1.42, 0.27, all n P0.05). At T3 and T4, there were no significant changes in levels of MAP, HR and SVR between the two groups compared with those at T0, and there were no significant significant differences between the two groups (alln P>0.05). The spontaneous breathing time, duration of eye opening, time of fist, time of removing tracheal catheter and time of returning to the ward in the mild group were slightly shorter than those in the moderate group (alln P>0.05).n Conclusion:When general anesthesia of sevoflurane inhalation is used in abdominal surgery of COPD patients, the trend of blood gas indicators is not affected by COPD, which can provide reference for clinical establishment of anesthesia regimens.