全身麻酔下全肺洗浄前後における動脈血酸素分圧の低下の左右比較

Comparison of Oxygen Partial Pressure during Lung Lavage under General Anesthesia

要旨

　肺胞タンパク症とは肺胞内にリン脂質やタンパク質などの物質が蓄積する原因不明の疾患で，根治的治療法は見つかっていない。治療として全身麻酔下の全肺洗浄が有効である。仰臥位での洗浄と比べ，洗浄肺を上にした側臥位により低酸素血症のリスクを低減できる可能性がある。洗浄順序は左肺から施行し，右肺は後日，洗浄する。両肺および片肺換気での酸素分圧は左右洗浄の両群間で有意差はなかったが，洗浄によりいずれも有意に低下した。

　Background：Alveolus proteinosis is a rare disease in witch materials such as phospholipids and proteins accumulate in the alveoli, and no curative treatment has been found. Total lung lavage under general anesthesia is considered effective.

　There are few reports on the anesthetic management of whole lung lavage under general anesthesia. In the present study, we investigated all cases enforced at our hospital and examined the results.

　Methods：This is a retrospective observational study conducted in 14 patients undergoing whole lung lavage. We recorded the partial pressure of oxygen and statistically examined them.

　Results：No statistically significant differences were found between the two groups. Decreased oxygenation was observed after lung lavage with both right and left lung.

　Conclusions：Comparison of oxygen partial pressure showed no significant difference between the two groups, but oxygenation remained relatively good during right lung lavage.