二氧化碳气腹时血液动力学和血浆心钠素的变化  

The effect of CO_2 pneumoperitoneum on plasma atrial natriuretic polypeptide concentration and hemodynamics

作　　者：王力甚[1] 饶瑞标[2] 倪蓉[1] 

机构地区：[1]湖北省荆州市中心医院,434100 [2]同济医科大学附属同济医院

出　　处：《中华麻醉学杂志》1999年第1期39-41,共3页Chinese Journal of Anesthesiology

摘　　要：目的　研究 CO2 气腹对血浆心钠素 ( ANP)、血液动力学和气道压力的影响。方法　腹腔镜胆囊切除术 ( L C)患者 4 2例 ,随机分成硫喷妥钠组 ( 2 5例 )和异丙酚组 ( 17例 )。在手术的不同阶段 ,抽取静脉血标本 ,用放射免疫法检测血浆中 ANP的浓度 ,同时记录心率、血压、血氧饱和度和气道压力的变化。结果　气腹后 10、3 0分 ,两组 ANP浓度较麻醉前明显降低 ( P<0 .0 5 ) ,气道压力则明显上升 ( P<0 .0 1)。两者均在消除气腹后恢复 ;气腹后血液动力学无明显变化 ( P>0 .0 5 )。结论　气腹可明显降低心脏 ANP的分泌 ,从而使 LObjecetive To study the effect of CO 2 pneumoperitoneum on plasma atrial natriuretic polypeptide level (ANP),hemodynamics and airway pressure (Paw).Methods Forty two patients undergoing elective laparoscopic cholecystomy (LC) were randomly assigned into 2 groups induced with either sodium thiopental (SP,4mg/kg) in 25 cases or propofol (PRO,2mg/kg) in 17 cases.Blood samples were drawn in given time intervals to determine the concentration of plasma ANP by radioimmunoassay.The vital signs and Paw were recorded at the same time.Results ANP level was significantly decreased (P<0 05) and Paw was significantly increased(P<0.01) 10 min and 30 min following pneumoperitoneum compared with pre anesthesia values,and were returned to normal after deflation.The hemodynamics remained unchanged after inflation.Conclusion Pneumoperitoneum can reduce the endocrine function of the heart resulting in the enhancement of stress response to LC.Excessive Paw should be avoided and the operation time be shortened.

关 键 词：心钠素 血液动力学 二氧化碳气腹 胆囊切除 

分 类 号：R657.4[医药卫生—外科学] R614[医药卫生—临床医学]