腹腔镜术中不同时期气腹压力对循环呼吸及血气参数的影响  

Effects of aeroperitoneal pressures on the circulation,ventilation and blood gas during gynecologic laparoscopic operation.

作　　者：钟蕙芳[1] 赵普文[1] 丁美芳[1] 程怀瑾[1] 

机构地区：[1]中国福利会国际和平妇幼保健院

出　　处：《中国实用妇科与产科杂志》1998年第6期351-352,共2页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：对３０例腹腔镜妇科手术病人分别观察在正常腹压、气腹压１３～１９ｋＰａ、气腹压２０～２７ｋＰａ三个不同时期腹压下循环、呼吸、血气参数的变化。结果显示：潮气量（ＴＶ）、气道峰压（Ｐｐｅａｋ）、呼气末ＣＯ２浓度（ＰｅｔＣＯ２）、二氧化碳分压（ＰａＣＯ２）、动脉血氧分压（ＰａＯ２）变化明显，比较在不同腹压下的参数相差显著或非常显著（Ｐ＜００５或００１）。提示：气腹压力超过２ｋＰａ对循环、呼吸影响较严重，尤其是妇科手术所致的特殊体位改变。因此，控制适当的气腹压对病人在术中的安全是至关重要的。Objective:To determine the effects of aeroperitoneal pressures on circulation,ventilation and blood gas during gynecologic laparoscopic operations.Methods:Thirty women undergoing laparoscopic gynecological operations were studied to investigate the effects of different aeroperitoneal pressures on circulation and respiration.Results:When the pressures were normal abdominal pressure,1 3～1 9kPa and 2 0～2 7kPa,the results showed that TV,Ppeak,PetCO 2,PaCO 2 and PaO 2 were significantly changed under different abdominal pressures(P<0 05 or P<0 01).Conclusions:If the abdominal pressure is over 2kPa,the effects on respiration and circulation were relatively obvious particularly in laparoscopic gynecological operations where a trendelenburg position is usually preferred.Therefore it is important to control aeroperitoneal pressure during laparoscopic gynecological operations.

关 键 词：气腹压力 循环 呼吸 血气参数 妇科手术 腹腔镜 

分 类 号：R713[医药卫生—妇产科学]