异丙酚对二氧化碳气腹中胃粘膜pH的影响.docVIP

异丙酚对二氧化碳气腹中胃粘膜pH的影响 刘晓玲 郑利民 王明玲 黄飞 张锦枝 王晓庆 （北京大学深圳医院，深圳，广东 518036） [摘要] 目的：本文旨在探讨通过两种全身麻醉方法即异氟醚单纯吸入和异氟醚、异丙酚静吸复合全麻观察异丙酚对腹腔镜下胆囊切除术CO2气腹过程中胃粘膜pH值的影响。方法：腹腔镜下胆囊切除术患者32例随机分为两组：异氟醚组（A组）和异丙酚组（B组），每组16例。于气腹前（T1）、气腹开始后40min（T2）、气腹结束后40min（T3）分别测定并记录胃粘膜与动脉血CO2分压差（P(i-a)CO2）、胃粘膜pH(pHi)值。结果：A、B两组T2时P(i-a)CO2均明显高于T1时，T3时P(i-a)CO2显著降低（P0.05）。与A组相比，B组于T2时P(i-a)CO2显著降低，pHi显著升高（P0.05）；与T1比较，两组T3时P(i-a)CO2和pHi基本恢复至T1水平。结论：异丙酚与异氟醚静吸复合麻醉有利于稳定CO2气腹过程中胃粘膜pH(pHi)，可能对维持CO2气腹过程中胃粘膜的血流灌注起到一定的积极作用，从而有利于患者术后的恢复和减少术后并发症的发生。 [关键词] 异氟醚　异丙酚　腹腔镜下胆囊切除术　胃粘膜pH值 Influence of Propoful on the gastric mucosa pH in CO2 aeroperitoneum operation Liu xiao-ling Zheng li-ming Wang min-ling Huang fei Zhang jin-zhi Wang xiao-qing Beijing University Shenzhen Hospital,Guangdong , Shenzhen ,518036 , china [Abstract] objective To study the influence of propoful under the two different general anesthetic (Isoflurane inhalation and Isoflurane- Propofol intravenous-inhalation combined anesthesia) on the gastric mucosa pH in CO2 aeroperitoneum operation. Methods Thirty-two patients underwent LC surgery were randomly divided into two groups. The patients were anesthetized Isoflurane (A group) or Propofol (B group). There were 16 patients in each group. The values of P(i-a)CO2 and pH of gastric mucosa were recorded at T1 ( before aeroperitoneum )、T2 (40 minutes after aeroperitoneum started) and T3(40 minutes after aeroperitoneum ended). Results: P(i-a)CO2 at T2 was significantly higher than that at T1 in both A group and B group, P(i-a)CO2 at T3 dropped significantly（P0.05） . P(i-a)CO2 at T2 in group B was significantly lower than that in group A. Phi T2 in group B was significantly higher than that in group A （P0.05）. The values of P(i-a)CO2 and pH at T3 almost retrieved at the level of T1. Conclusion: Isoflurane- Propofol intravenous-inhalation combined anesthesia is in favor of stabling the PH value of gastric mucosa during CO2 aeroperitoneum . It improves the blood perfusion of g