目的 基于呼吸力学、心肌损伤、术后肺部并发症来探讨压力控制容量保证通气模式（PRVC）用于心脏瓣膜手术的价值。 方法 前瞻性纳入2024年1月至2025年10月徐州医科大学附属医院收治的择期行心脏瓣膜置换或修复术患者，严格纳入与排除标准后最终入组100例，以分层区组随机化方法按1∶1比例将患者分配至PRVC组（n = 50）与对照组（n = 50，容量控制通气模式），比较两组手术不同时间呼吸力学、氧合状态，测定术前术后肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、超敏肌钙蛋白T（hs-cTnT）、N端脑钠肽前体（NT-proBNP）水平，记录术后7 d内肺部并发症发生情况。 结果 不同时间点，PRVC组P_peak、P_plat、△P均低于对照组，Cdyn高于对照组，存在组间与时间效应（P < 0.05），P_peak存在交互效应（P < 0.05）；不同时间点，PRVC组PaO₂、OI均高于对照组，RI、P_A-aO₂低于对照组，存在组间与时间效应（P < 0.05），其中PaO₂、P_A-aO₂存在交互效应（P < 0.05）；术后6、24 h两组CK-MB、LDH、hs-cTnT、NT-proBNP均高于同组术前，PRVC组术后6、24 h CK-MB、LDH、hs-cTnT、NT-proBNP低于对照组，存在组间、时间及交互效应（P < 0.05）；PRVC组拔管时间、ICU停留时间及总住院时间短于对照组（P < 0.05），术后总肺部并发症发生率显著低于对照组（P < 0.05）。 结论 PRVC模式用于心脏瓣膜手术较VCV模式对呼吸力学、氧合影响更小，肺保护作用显著，可减轻心肌损伤，减少肺部并发症。

Objective To explore the value of pressure regulated volume-controlled ventilation mode （PRVC） in cardiac valve surgery based on respiratory mechanics， myocardial injury and postoperative pulmonary complications. Methods A prospective study included patients admitted to the affiliated Hospital of Xuzhou Medical University for elective cardiac valve replacement or repair from January 2024 to October 2025. After strict inclusion and exclusion criteria， a total of 100 cases were finally enrolled. Patients were assigned to the PRVC group （n = 50） and the control group （n = 50， volume-controlled ventilation mode） in a 1∶1 ratio by stratified block randomization. The respiratory mechanics and oxygenation status of the two groups at different times after surgery were compared. The levels of creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， hypersensitive troponin T （hs-cTnT）， and N-terminal pro-brain natriuretic peptide （NT-proBNP） before and after surgery were determined. The occurrence of pulmonary complications within 7 days after surgery was recorded. Results At different time points， the P_peak， P_plat and △P in the PRVC group were all lower than those in the control group， while Cdyn was higher， with intergroup and time effects （P < 0.05）， and with an interaction effect on P_peak （P < 0.05）. At different time points， the PRVC group had higher PaO₂ and OI， while lower RI and P_A-aO₂ were lower， with intergroup and time effects （P < 0.05）， among which there was an interaction effect of PaO₂ and P_A-aO₂ （P < 0.05）. At 6 hours and 24 hours after surgery， the levels of CK-MB， LDH， hs-cTnT and NT-proBNP in both groups were higher than those before surgery in the same group， and those in the PRVC group were lower. There were intergroup， time and interaction effects （P < 0.05）. The extubation time， ICU stay time and total hospital stay in the PRVC group were shorter （P < 0.05）， and the total incidence of postoperative pulmonary complications was significantly lower （P < 0.05）. Conclusions The PRVC mode used in cardiac valve surgery has less impact on respiratory mechanics and oxygenation than the VCV mode， has a significant lung-protective effect， can reduce myocardial injury and decrease pulmonary complications.