Molchanov I V, Ravikovich M A, Mel'nikov A M, Sannikov V P
Zh Vopr Neirokhir Im N N Burdenko. 1988 May-Jun(3):32-4.
The authors examined 80 patients who underwent operation on the brain and upper parts of the spinal cord. The control group of patients who had been operated on in the same period of time did not differ essentially from the group studied in number, sex, age, character and severity of the operative interventions, and the principles of postoperative intensive therapy. All the patients had no concomitant pathological conditions of the organs of respiration and circulation and required prolonged postoperative artificial ventilation of the lungs (AVL). High-frequency artificial ventilation of the lungs (HF AVL) was conducted in 40-minute sessions in the first 2-3 postoperative days at a frequency of 120 respiratory cycles per minute. The values of pressure in the trachea and right parts of the heart, arterial pressure, and rate of heart contractions were recorded; the thoracic organs were regularly examined by X-ray, the results of postmortem examination were analysed. It is shown that HF AVL is attended by tension of the compensatory mechanisms of the cardiovascular system, but the sessions are tolerated by the patients well and create conditions for neurological appraisal of the person who is operated on, as a result of which neurosurgical correction can be conducted in good time. The application of the AVL method in sessions is an effective measure for the prevention of postoperative pulmonary complications.
作者对80例接受脑部和脊髓上部手术的患者进行了检查。同期接受手术的对照组患者在手术干预的数量、性别、年龄、性质和严重程度以及术后强化治疗原则方面与研究组没有本质区别。所有患者均无呼吸和循环器官的合并病理状况，且术后需要长时间的肺部人工通气（AVL）。术后头2至3天，高频肺部人工通气（HF AVL）以每分钟120次呼吸周期的频率进行40分钟的疗程。记录气管和心脏右侧的压力值、动脉压和心脏收缩率；定期对胸部器官进行X线检查，分析尸检结果。结果表明，HF AVL伴随着心血管系统代偿机制的紧张，但患者对这些疗程耐受性良好，并为接受手术者的神经学评估创造了条件，从而能够及时进行神经外科矫正。在疗程中应用AVL方法是预防术后肺部并发症的有效措施。
