腹腔镜胆囊切除术中CO2气腹对呼吸、循环和血气的影响介绍.doc

腹腔镜胆囊切除术中气腹对呼吸、循环的影响 王祖谦1 马远忠2 青海大学附属医院1青海大学医学院 2 【摘要】目的 全身麻醉下行腹腔镜胆囊切除术（LC））CO2分压，动脉血气的数值。结果 与T1相比，T2、T3、T4各时点的Pmean、Peak、SBP、DBP、MAP、PH、BE均较气腹前（T1））Pmean、PeakT3、T4时的值与T2比较无明显变化；PetCO2、PaCO2气腹后迅速升高，但T2与T1比较差异无显著性（P0.05））CO2 气腹对呼吸、循环功能及动脉血气影响显著，并且PetCO2与PaCO2具有良好的相关性。 关键词 腹腔镜胆囊切除术；全身麻醉；二氧化碳气腹；动脉血气 Effect of CO2 pneumoperitoneum on circulation、respiratory function and blood gas in Laparoscopic cholecystectomy 【Abstract】Objective To observe the effect of carbon dioxide pneumoperitoneum on the function of circulation、respiratory systems and blood gas in laparoscopic cholecystectomy(LC).Methods Seventeen ASAⅠ～Ⅱ patients who will undergo laparoscopic cholecystectomy at general anesthesia were choosen into the study.Monitoring and recording the data of airway pressure、blood pressure、PetCO2 and arterial blood gas at the time of 5 minutes after anesthesia(T1)(before pneumoperitoneum)、 5 minutes (T2)、10 minutes (T3)、20 minutes after pneumoperitoneum(T4).Results Compared with T1 the data of Pmean、Peak、SBP、DBP、MAP、PH、BE is higher at T2、T3、T4 ，and there are significant difference（P0.05）.The value of HR、HCO3-、PaO2、a/A 、Sao2、TCO2 and Pa-etCO2 in the observed time there is no obvious changes（P0.05）.The value of Pmean、Peak is higher than T1 at the time of T2,but there is no significant changes among T3、T4 and T2.The data of PetCO2、PaCO2 step up quickly after pneumoperitoneum,but there are no differences between T2 and T1 and that T3、T4 are become higher than T1 but it becomes more and more slowly.Conclusion CO2 pneumoperitoneum has a significant influence on cardiovascular、respiratory systems and arterial blood gas in laparoscopic cholecystectomy(LC) and there is a favourable dependablity between PaCO2 and PetCO2. 【Keywords】Laparoscopic cholecystectomy；anesthesia； CO2 pneumoperitoneum； arterial blood gas ( Laparoscopic cholecystectomy,LC) 因其手术创伤小、术后疼痛轻、恢复快、腹部疤痕小、住院时间短等优点已被临床广泛应用.本文旨在观察西宁地区腹腔镜胆囊切除术中CO2气腹对呼吸、循环功能的影响。 资料与方法 一般资料 选择ASAⅠ～Ⅱ级、心肺功能无异常者，无神经内分泌系统疾病及其他合并症，无全身麻醉禁忌症的患者17例