腹腔镜二氧化碳气腹对婴幼儿围手术期呼吸、循环的影响  

Effects of Laparoscopic Carbon Dioxide Pneumoperitoneum on Infants Perioperative Respiratory and Circulatory

作　　者：唐世龙[1] 李君久[1] 陈敏[1] 肖梅[1] 黎东伟[1] 陈展辉[1] 张小兵[1] 陈剑[2] 刘才堂[2] 

机构地区：[1]中山大学附属东华医院普外科,广东东莞523110 [2]中山大学附属东华医院麻醉科,广东东莞523110

出　　处：《实用儿科临床杂志》2011年第18期1455-1457,共3页Journal of Applied Clinical Pediatrics

基　　金：广东省东莞市科技计划资助项目(200910515000244)

摘　　要：目的观察腹腔镜手术二氧化碳(CO2)气腹对婴幼儿围手术期呼吸和循环功能的影响,并探讨应对措施。方法选择1个月～3岁的婴幼儿进行分组:A组(婴儿组),B组(幼儿组),C组(开腹手术组)。观察各组气腹前5 min(T0)、气腹后5 min(T1)、气腹后30 min(T2)及停止气腹10 min(T3),各组患儿的心率(HR)、血氧饱和度(SpO2)、血压(SBP/DBP)、血气分析结果[pH、pa(CO2)、pa(O2)]等指标。采用SPSS 13.0软件进行统计学处理。结果 A、B 2组气腹后T1、T2与气腹前T0相比HR、pa(CO2)、SDP、DBP均增高(Pa<0.05),血pH值、SpO2、pa(O2)均无明显变化(Pa>0.05);A、B 2组气腹停止后T3的监测数据与气腹前T0相比无明显变化。A、B 2组气腹后T1、T2与C组比较,pa(CO2)分压增高(P<0.05),其他监测数据差异无统计学意义。结论腹腔镜CO2气腹对婴幼儿围手术期呼吸和循环功能有明显影响,加强麻醉管理,精确手术操作,婴幼儿腹腔镜手术仍是安全的,不会明显增加手术风险。Objective To observe the effects of laparoscopic carbon dioxide（CO2） pneumoperitoneum on infants perioperative respiratory and circulatory and explore the measures. Methods One month to 3-year-old infants were divided into 3 groups： group A（infant group）,group B（young children group）,group C（laparotomy group）.The patients in each group were recorded heart rate（HR）,oxygen saturation（SpO2）, systolic blood pressure（SBP） and diastolic blood pressure（DBP）,blood gas analysis data：pH, carbon dioxide partial pressure[pa（CO2）], oxygen concentration [pa（O2）].The datum were recorded for 5 minutes before pneumoperitoneum（T0）,5 minutes after pneumoperitoneum（T1）,30 minutes after pneumoperitoneum（T2） and 10 minutes after stop pneumoperitoneum（T3）.Data were analyzed statistically by SPSS 13.0 software. Results Compared with T0 in group A and B,HR,p（CO2）,SBP and DBP at T1 and T2 were significantly higher（Pa0.05）;blood pH,SpO2,pa（O2） had no significant change（Pa0.05）;compared with T0 the monitoring data at T3 were no significant change.T1,T2 in group A and B compared with group C,the pa（CO2） had increased（P0.05）,other monitoring data were not statistically significant. Conclusions Laparoscopic CO2 pneumoperitoneum on infants and young children perioperative respiratory and circulatory functions have a more significant effect;Strengthening the anesthetic management and precise surgical procedures,infant laparoscopic surgery is safe and does not significantly increase the risk of surgery.

关 键 词：腹腔镜术 气腹 呼吸系统 心血管系统 婴幼儿 

分 类 号：R726.5[医药卫生—儿科]