腹腔镜幽门肌切开术CO2气腹对呼吸循环及血气分析指标的影响  

Effect of carbon dioxide pneumoperitomeum during laparoscopic pyloromyotomy

作　　者：任红霞[1] 陈兰萍[1] 陈淑芸[1] 韩湘珍[1] 吴晓霞[1] 孟庆明[1] 王计文[1] 张旭辉[1] 靳文[1] 田雨[1] 

机构地区：[1]山西省儿童医院外科,太原030013

出　　处：《中华小儿外科杂志》2008年第2期88-90,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨腹腔镜幽门肌切开术CO2气腹对患儿呼吸循环及血气分析指标的影响。方法监测20例腹腔镜下幽门环肌切开术患儿呼吸循环及血气分析指标。结果气腹后10min、20min潮气量（VT）明显降低，亦明显低于撤销气腹后5min值，差异均有统计学意义（P〈0．05）；气腹后10min、20min呼气末CO2值（PetCO2）明显增高，与气腹前相比差异有统计学意义（P〈0．05），撤销气腹后5minPetCO2值略有下降，与气腹前相比差异有统计学意义（P〈0．05）。气腹后收缩压（DBP）、舒张压（SBP）、平均动脉压（MAP）、血氧饱和度（SpO2）、心率（HP）、气道压（Peak）、肺顺应性（CL）各值均有改变，与术前比较差异无统计学意义。结论小婴儿腹腔镜手术中，CO2气腹主要可引起VT、PetCO2的改变，只要术中完善呼吸和循环系统的监测，并采取相应措施，小婴儿腹腔镜手术和麻醉是安全可行的。Objective To investigate the effect of carbon dioxide pneumoperitomeum on children＇s respiration and circulation during laparoscopic pyloromyotomy. Methods Twenty patients who underwent laparoscopic pyloromyotomy were studied. The respiration and circulation indices were measured on each patient at certain intervals. Results Ten to twenty minutes after the establishment of pneumoperitoneum, the tidal volume declined. The volume was significantly lower than that 5 minutes after reversal of pneumoperitoneum （P〈0. 05）. Pet CO2 was significantly higher than the pre - pneumoperitoneum value （P〈0. 05）. Five minutes after the withdraw pneumoperitoneum, PetCO2 declined slightly yet it was still significantly higher than the pre-pneumoperitoneum value （P〈0. 05）. The diastolic blood pressure, systolic blood pressure, mean arterial pressure, oxygen saturation, heart rate, air way peak pressure and lung compliance were all deranged but the changes were not significant compared to the pre-pneumoperitoneum values. Conclusions Carbon dioxide pneumoperitomeum can affect the tidal volume and PetCO2 in neonates and infants. Being aware of these changes is crucial to minimizing untoward effects in the laparoscopic surgeries in neonate and young infants.

关 键 词：气腹 人工 腹腔镜外科手术 血气分析 

分 类 号：R726.1[医药卫生—儿科]