高原地区腹腔镜胆囊切除术CO_2气腹对心律的影响  

Impact of Laparoscopic Cholecystectomy CO_2 Pneumoperitoneum on Heart Rhythm at High Altitude

作　　者：王育红[1] 王同猛 尚安云[1] 李宏文[1] 

机构地区：[1]解放军第22医院麻醉科,青海格尔木816000

出　　处：《临床军医杂志》2009年第1期49-50,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨高原地区LCCO2气腹对心律的影响。方法我院近年来施行316例LC,其中17例于气腹过程中出现心律失常,对其发生原因和防治进行回顾分析。结果腹腔注入CO2后出现窦性心动过缓12例,室性期前收缩3例,房室分离2例,均于对症处理后恢复正常。其原因可能与腹腔快速充气、腹腔压力增加及全身麻醉药对心血管的抑制作用有关。结论高原地区行CO2气腹时充气要缓慢,使机体对腹内压的增高有一个适应的代偿时间,以减少心律失常的发生,一旦出现心律失常只要及时处理,都能较快恢复。Objective To explore the impact of laparoscopie eholecystectoiny （LC） CO2 pneumoperitoneum on cardiac rhythm in highlands. Methods LC were performed in 316 patients, of whom 17 suffered arrhythmias during CO2 pneumoperitoneum. The possible causes, as well as the prevent or treatment, were retrospectively analyzed. Results Sinus bradycardia occurred in 12 patients after the CO2 was compressed into the abdominal cavity, and premature ventricular systole and atrioventrieular dissociation occurred respectively in 3 and 2 ones. All the cardiac arrhythmias return to normal when treated. The reasons might be related to the over-fast abdomiral cavity gas filling, the increase in intra-abdominal pressure and the anesthetic-related cardiovascular inhibition. Conclusion It is suggested that LC CO2 pneumoperitoneum is performed at a slow speed during inflation at high altitude, so that the human bodies gain a time to adapt to the increased intra-abdominal pressure and the arrhythmias can be reduced. The arrhythmias should be treated in time as soon as they occur.

关 键 词：高海拔 气腹 心律失常 

分 类 号：R657.4[医药卫生—外科学]