腹腔镜胆囊切除术中不同气腹压力对呼吸循环系统影响观察及护理.docVIP

腹腔镜胆囊切除术中不同气腹压力对呼吸循环系统影响观察及护理[摘要] 目的：探讨不同气腹压力对腔镜胆囊切除手术病人呼吸循环系统的影响。方法：选择全麻插管下经腹腔镜行胆囊切除术病人100例，随机分为H组和L组，H组50例，L组50例。H组病人全麻后开始气腹时，气腹压力设定为13~15 mmHg，持续给予病人气腹至气腹压力恒定。L组病人全麻后开始气腹时，气腹压力设定为8~12 mmHg，间断给予病人气腹至气腹压力恒定。观测两组病例气腹前，气腹后2 min、10 min、放气后的BP，HR，SpO2的情况。结果：气腹后2 min、10 min SBP、HR、SpO2均有不同程度的降低，与气腹前相比，H组气腹后2 min SBP、HR、SpO2有明显变化（P＜0.01），气腹后10 min SBP、HR、SpO2有变化（P＜0.05）；而L组仅气腹后2 min SBP、HR、SpO2有变化（P＜0.05）。2组病例比较，H组气腹后2 min、10 min SBP、HR、SpO2均低于L组（P＜0.05）。结论：腔镜手术时，高气腹压力对病人呼吸循环系统影响较为明显，术中应避免持续高气腹压力，宜均匀缓慢进气。同时加强护理，以维持呼吸循环功能的稳定。 [关键词] 腹腔镜；气腹压力；呼吸循环影响；护理 [中图分类号]R473.6 [文献标识码]C [文章编号]1673-7210（2008）07（a）-164-02 The observation and nursing of the impact on the circulatory system of respiration caused by different pneumoperitoneal pressure during lapariscopic cholecystectomy LUO Xiang-lian （The Third People’s Hospital of Yiyang City in Hunan Province，Yiyang 413002，China） [Abstract] Objective：Explore different pneumoperitoneum pressure on laparoscopic cholecystectomy surgery patients circulatory system of breathing. Methods：Choose intubation under general anesthesia，as laparoscopic cholecystectomy patients 100 cases were divided into group H and L group，group H 50 cases，L Group 50 cases. Group H after general anesthesia patients began pneumoperitoneum，pneumoperitoneum pressure set at 13~15 mmHg， sustained abdominal disease popularity constant pressure to pneumoperitoneum. Group L patients anesthesia after pneumoperitoneum，pneumoperitoneum pressure set at 8~12 mmHg，the popularity of intermittent abdominal given to constant pressure pneumoperitoneum. Two cases of pneumoperitoneum observation before pneumoperitoneum started two minutes,ten minutes when BP，HR， SpO2 situation. Results：Two cases started after pneumoperitoneum BP，HR， SpO2 had different levels of lower， compared with the former pneumoperitoneum group H P＜0.01， L， P＜0.05，group H case BP， HR， SpO2 change more obvious. Compared with L P＜0.05.Conclusion: Endoscopic surgery，high pneumoperitoneum pressure on