腹腔镜手术中二氧化碳气腹对动脉血气及血流动力学的影响  

The Effects of CO_2 Pneumoperitonum on Arterial Blood Gas Tensionand Hemodynamics During Laparoscopic Surgery.

作　　者：倪蓉[1] 王力甚[1] 倪娟 

机构地区：[1]长江大学附属荆州市中心医院,湖北荆州434020 [2]湖北省荆州市胸科医院,湖北荆州434023

出　　处：《湖北省卫生职工医学院学报》2004年第4期23-25,共3页Journal of Hubei Medical Staff College

摘　　要：目的 :探讨腹腔镜手术中二氧化碳气腹对动脉血气和血流动力学的影响。方法 :选取择期作腹腔镜手术的患者 2 2例 ,其中腹腔镜胆囊切除术 (LC) 10例、输卵管囊肿 8例、浆膜下肌瘤 2例、子宫内膜异位症 2例。分别在气腹前、气腹后 0、 15、 30、 6 0、 90min和气腹毕各个时间内抽取桡动脉血液作血气分析 ,同时监测心率、血压等生命体征的变化。结果 :与气腹前比 ,气腹后 15min至气腹毕 ,PaCO2 明显升高 (P <0 0 5 ) ,而pH、PaO2 和SaO2 无明显变化 (P >0 0 5 ) 。结论 :CO2 气腹可明显提高PaCO2 ,造成高碳酸血症 ,从而加剧血液生理紊乱。提示气腹手术中应增加潮气量 ,以降低PaCO2 。Objective:To study the effect of CO 2 pneumoperitonum on arterial blood gas tension. Method:22 cases of patients undergoing laparoscopic surgery were randomly chosen. Artery blood samples were drawn to measure pH、PaCO 2 and SaO 2 ,The vital signs were monitored simultaneously. Results: PaCO 2 was significantly increased 15 min after pneumoperitonum until deflation,compared with pre-inflation value (P<0.05); pH and SaO 2 remained unchanged. Conclusion:PaCO 2 can obviously interfere with the biochemistry of blood. More attention should be paid during pneumoperitoneum to hypercapnemia and thus we suggest increasing Vt during the operation.

关 键 词：腹腔镜手术 人工气腹 动脉血气 血液动力学 

分 类 号：R725.7[医药卫生—儿科]