颈部内窥镜手术充co- c-和he对代谢、血液动力学和颅内压影响实验的研究.docxVIP

上海交通大学硕士学位论文THE EXPERIMENTAL RESEARCH FOR THE EFFECT OFCERVICAL CO2 AND HELIUM INSUFFLATION ONMETABOLIC, HEMODYNAMIC AND INTRACRANIALPRESSURE IN ENDOSCOPIC NECK SURGERYABSTRACTObjective: Carbon dioxide and helium were insufflated into the neck ofrabbits to investigate the effect of different levels of insufflation pressure andduration on metabolic, hemodynamic and intracranial pressure changes.Methods: Fifteen New Zealand rabbits were randomly divided into 5groups: 5mmHgCO2, 10 mmHgCO2, 15 mmHgCO2, 15mmHgHe and 0mmHg. Arterial partial pressure of CO2 (PaCO2), pH, heart rate (HR), meanarterial pressure (MAP), central venous pressure (CVP) and intracranialpressure (ICP) were measured at baseline, 45min and 90min after gasinsufflation and 30min after desufflation.Results: Insufflation of CO2 at 5mmHg did not have any significant上海交通大学硕士学位论文effect on the parameters. PaCO2 increased significantly 45min and 90minafter CO2 insufflation at 10mmHg (p0.05). Marked changes in PaCO2, pH,CVP and ICP occurred 45min and 90min after CO2 insufflation at 15mmHg(p0.05), and the parameters did not return to baseline 30min afterdesufflation. In animals receiving He insufflation at 15mmHg, CVP increasedsignificantly after 90min (p0.05), ICP elevated significantly after 45min and90min (p0.05), and the two parameters returned to baseline 30min afterdesufflation. Animals receiving He insufflation did not experiencehypercapnia. No significant changes in HR and MAP occurred in all animals.Conclusion: Carbon dioxide insufflation for endoscopic neck surgery issafe below 10mmHg. When higher pressure is required, the level lower than15mmHg is recommended and the insufflation duration should be limited.The use of He should be careful due to the low solubility.KEY WORDS ： CO2 ， Helium ， Neck ， Endoscopy ， Metabolic ，Hemodynamic，Intracranial Pressure上海交通大学学位论文原创性声明本人郑重声明：所呈交的学位论文，是本人在导师的指导下，独立进行研究工作所取得的成果。除文中已经注明引用的内容外，本论文不包含任何其他个人或集体已经发表或撰写过的作品成果。对本文的研究做出重要贡献的个人和集体，均已在文中以明确方式标明。本人完全意识到本声明的法律结果由本人承担