腹腔镜下胆囊切除术中不同呼吸参数的比较  

Comparison Among Different Bream Parameters in Laparoscopic Chotecystectomy

作　　者：游志坚[1] 游玉琼 徐红霞[1] 陈利民[1] 

机构地区：[1]广州军区武汉总医院麻醉科,武汉430070 [2]湖北省洪湖三医院

出　　处：《华南国防医学杂志》2005年第3期28-29,共2页Military Medical Journal of South China

摘　　要：目的比较腹腔镜下胆囊切除术时不同呼吸参数对呼吸动力学和动脉血气的影响,并选择最佳呼吸参数。方法胆襄炎患者100例,随机分成5组(A,B,C,D,E组)各20例,设置分钟通气量为100ml/Kg,呼吸频率各组依次为12,14,16,18,20次/min,监测气腹前和气腹后20min的气道峰压(Peak)及动脉血气分析(包括PaO2、PaCO2、SaO2)。结果气腹前动脉血气示PaO2,SaO2正常,PaCO2均处于30-40mmHg之间;气腹后20min动脉血气示PaO2,SaO2正常,PaCO2各组有增高,与气腹前相比较A,B,C组差异无显著性(P>0.05),而D、E组差异有显著性(P<0.01)。气腹后各组气道峰压(Peak)增高,与气腹前相比较差异有显著性(P<0.01)。结论腹腔镜手术中分钟通气量为100ml/Kg时,RR为16次/min既能防止气道压过高,又能保证病人通气,是较为理想的选择。Objectives To explore the effects of different breath parameters on respiratory dynamics and arterial blood gas in laparoscopic cholecystectomy under general anesthesia and to select the better breath parameter .Method One hundred patients with cholecystitis of ASA grade Ⅰ-Ⅱ were randomly divided into five groups (A,B,C,D,E.n = 20) .The ventilation volume per minute was set at 100ml/kg and breath frequency in groups A,B,C,D and E were set at 12,14,16,18,20 times per minute respectively. Peak of airway pressure (Peak) and blood gas analysis of arteries were monitored.Results Compared with those before pneumoperitoneum.PaCO2 increased significantly ( P < 0.01) in group D and group E, and the Peak increased significantly ( P < 0.01) in all the groups. Conclusion It is the better breath parameters that ventilation volume is 100ml/kg per minute and breath frequency is 16 times/min in laparoscopic cholecystectomy.

关 键 词：腹腔镜 呼吸参数 胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]