Objective To investigate the effect of positive end expiratory pressure (PEEP)on oxygenation and shunt in patients with one lung ventilation (OLV)after pulmonary lobotomy.Methods 70 patients after pulmo-nary lobotomy were randomly divided into two groups,35 cases in each group.While the tide volume of OLV was 6ml/kg and respiratory frequency was 16~18 times/min,the observation group was given PEEP 5cmH2O at the same time,and the control group wasn't given PEEP.Blood gas analysis,mean pulmonary arterial pressure (PAP),mean arterial pressure (MAP),heart rate (HR),arterial partial pressure of oxygen (PaO2 ),mixed venous oxygen satura-tion (SvO2 )and intrapulmonary shunt (Qs /Qt)were observed at the following time points:two-lung ventilation (T1 ),solitary lung ventilation 1 0min (T2 ),and one lung ventilation 30min(T3 ).Results The level of PaO2 de-creased more significantly at the time points of T2 and T3 than at T1 in the control group (t=7.528,6.767,P=0.000),and it was higher at the time points of T2 and T3 in the observation group than in the control group (t=5.434,3.852,P=0.000,0.001 ).There was no significant difference in PH,PaCO2 ,BE,and HCO3-at different time points between the two groups.Conclusion PEEP can improve oxygen partial pressure and decrease intrapul-monary shunt when the patients with OLV is underwent pulmonary lobotomy.%目的：探讨肺叶切除患者单肺通气（OLV）时应用呼气末正压通气（PEEP）对氧合及分流的影响。方法将70例肺叶切除患者随机分为两组，每组35例，两组在OLV时潮气量6 ml／kg，呼吸频率16～18次／min，观察组同时应用PEEP 5 cmH2 O，对照组不用PEEP，比较两组患者双肺通气时（T1）、单肺通气10 min （T2）及单肺通气30 min（T3）血气分析结果及平均肺动脉压（PAP）、平均动脉压（MAP）、心率（HR）、动脉血氧分压、混合静脉血氧饱和度（SvO2）及肺内分流率（Qs／Qt）。结果对照组T2、T3时间点PaO2较T1时下降（t＝7.528、6.767，P＝0.000、0.000），T2、T3时间点观察组PaO2高于对照组（P＝0.000），PH 值、PaCO2、BE 、HCO3－各时间点组内、组间比较差异均无统计学意义；T2、T3时间点观察组Qs／Qt 较分别较对照组降低（t＝12.011、9.992，P＝0.000、0.000），差异均有统计学意义，两组PAP、MAP、HR、SvO2各时间点组间、组内比较差异均无统计学意义。结论肺叶切除手术OLV时应用PEEP可提高氧分压，降低肺内分流，是防治低氧血症的有效措施之一。
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