目的 观察驱动压（DP）指导通气策略对婴儿胸腔镜手术单肺通气（OLV）时脑氧饱和度（S_rcO₂）的影响。 方法 60例择期胸腔镜手术婴儿随机分成对照组（C组）和驱动压力组（DP组），每组30例。通过近红外光谱仪监测S_rcO₂，以S_rcO₂较基线下降> 20%为低脑氧合（COD）。记录OLV期间低血压发生率、通气补救次数、COD发生率及其持续时间。比较两组婴儿胸人工气胸前（T₁）、人工气胸后30 min（T₂）和人工气胸后60 min（T₃）的MAP、HR、S_rcO₂、PEEP、气道峰压（P_peak），肺静态顺应性（C_s），以及人工气胸前后的动脉血气分析结果。 结果 两组在S_rcO₂基线、OLV时S_rcO₂平均值、低血压发生率、COD发生率上均差异无统计学意义（P > 0.05）。DP组通气补救次数和COD持续时间均低于C组（P < 0.05）。两组患儿在T₁时的MAP、HR、S_rcO₂、P_peak 、C_s、P_aO₂和OI均差异无统计学意义（P > 0.05）。与T₁相比，两组患儿在T₂和T₃时P_peak均升高，S_rcO₂和C_s降低（P < 0.05）。与C组相比，DP组在T₂时P_aO₂和OI更高，T₂和T₃时P_peak更低，PEEP和C_s更高（P < 0.05）。DP组患儿气管拔管时间和PACU停留时间短于C组（P < 0.05）。两组患儿苏醒延迟、二次气管插管和术后躁动的发生率差异均无统计学意义（P > 0.05）。 结论 DP通气策略可改善通气侧肺部顺应性，提高婴儿OLV时的氧合水平，缩短COD暴露时间。

Objective To investigate the effect of driving pressure （DP） guided ventilation strategy on regional cerebral oxygen saturation （S_rcO₂） in infants with one lung ventilation （OLV） during thoracoscopic surgery. Methods Sixty infants undergoing elective thoracoscopic surgery were randomly divided into control group （group C，n = 30）and driving pressure group （group DP， n = 30）. Near?infrared spectroscopy was used to monitor S_rcO₂ during OLV. Cerebral oxygen desaturation （COD）was defined as SrcO2 decreased by more than 20% from baseline. The incidence of hypotension， time of ventilation rescue， the incidence of COD and its duration during OLV were recorded. MAP， HR， S_rcO₂， PEEP， airway peak pressure （Ppeak）， static lung compliance （Cs） were recorded before （T₁）， 30 min after （T₂） and 60 min after （T₃）artificial pneumothorax， and results of arterial blood gas analysis on T₁ and were T₂ compared. Results There were no significant differences in the S_rcO₂ baseline， the mean S_rcO₂ during OLV， the incidence of hypotension and the incidence of COD between the two groups （P > 0.05）. Times of ventilation rescue and COD duration in DP group were lower than those in C group（P < 0.05）. There were no significant differences in MAP， HR， S_rcO₂， Ppeak， Cs， PaO₂ and OI between the two groups at T₁ （P > 0.05）. Compared with T₁， Ppeak increased and S_rcO₂ and Cs decreased in both groups at T₂ and T₃ （P < 0.05）. Compared with group C， group DP had higher PaO₂ and OI at T₂， lower Ppeak and higher PEEP and Cs at T₂ and T₃（P < 0.05）. Conclusion DP guided ventilation strategy improved lung compliance， increased oxygen saturation and shortened the exposure of COD in infants during OLV.