腹腔镜胆囊切除术麻醉管理与监测.DOCVIP

临床医学论文-腹腔镜胆囊切除术麻醉管理与监测 【关键词】? 血氧饱和度 　　【摘要】? 目的? 观察腹腔镜胆囊切除术（LC）中，血氧饱和度（SpO2）、血压（BP）的变化特点。方法 对40例胆囊结石、5例胆囊息肉患者选择气管插管静脉复合麻醉，其中5例加用硬膜外阻滞麻醉，术中观察SpO2、BP，分析术毕SpO2和拔气管导管时间。结果? 术中1例出现短时间SpO2下降＜85%，2例＜95%，93%以上维持在96%～100%，术毕有40例（88.9%）SpO2维持在99%～100%，4例（8.9%）维持在97%～98%，仅有1例为96%；术中有2例BP下降至（76～85）/（48～53）mmHg，术后拔管时间最长50min，最短为5min内，平均18.1min。结论 腹腔镜胆囊切除术需CO2气腹下完成，对呼吸和循环系统有明显影响，术中连续监测SpO2、BP，有助于避免各种并发症发生。 　　【关键词】? 胆囊切除术，腹腔镜；麻醉管理；血氧饱和度??? 　　Management and monitoring of anesthesia in laparoscopic cholecystectomy 　　【Abstract】? Objective? To observe the changing features of oxygen saturation(SpO2） and blood pressure (BP） during laparoscopic cholecystectomy (LC）.Methods? We combined tracheal intubation anesthesia and intravenous anesthesia for 40 gallbladder calculus patients and 5 gallbladder polyp patients.Additionally,we gave epidural blockade anaesthesia for 5 patients among the 45 foresaid ones.Observing SpO2 and BP during the surgery,and analyzing the SpO2 and the time of decannulating the endotracheal tube after the surgery were carried out.Results? During the surgery,only 1 patients SpO2 descended less than 85% for a while,2 patients descended less than 86% to 95%,while the balance patients stayed between 96% and 100%.After the surgery,40 patients (88.8%） SpO2 stayed between 99% and 100%,4 patients(8.8%） stayed between 97% and 98%,only 1 patients stayed 96%.During the surgery,2 patients BP descended to 76～85/48～53mmHg.It took 5 to 50 minutes to decannulate the endotracheal tube after the surgery,and the average time was 18.1 minutes.Conclusion? The laparoscopic cholecystectomy (LC） needs to be performed with the CO2 insufflation.Since the laparoscopic cholecystectomy (LC） affects respiratory system and circulatory system obviously,continuous monitoring the SpO2 and BP can help to prevent various complications during the surgery. 　　【Key words】? cholecystectomy,laparoscopic;anaesthesia management;oxygen saturation 　　腹腔镜胆囊切除术（LC）具有手术创伤小、恢复快等特点，已被广泛应用。但由于腹腔镜胆囊切除术需要向腹腔内注入二氧化碳造成气腹