呼吸频率及潮气量对老年CO_2气腹患者呼吸功能及胃黏膜pH值变化的预测价值  

Forecast value of repiratory frequency and tidal volume for changes of CO_2 pneumoperitoneum on respiratory system and gastric intramucosal p H of aged patients during laparoscopic cholecystectomy

作　　者：李新丰[1] 黎冉[2] 王高雄[1] 黄天从[1] 

机构地区：[1]福建医科大学附属第二医院肝胆胰外科,泉州362000 [2]福建医科大学附属第二医院麻醉科,泉州362000

出　　处：《中华诊断学电子杂志》2014年第1期44-46,共3页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：泉州市科技项目社会发展科技医疗卫生类(2013Z54)

摘　　要：目的研究呼吸频率及潮气量在腹腔镜胆囊切除中CO_2气腹对老年患者呼吸功能及胃黏膜pH值(pHi)的影响。方法 42例腹腔镜胆囊切除CO_2气腹的老年患者(≥65岁),在全麻CO_2气腹压力为13 mm Hg(1 mm Hg=0.133 k Pa),依术中呼吸频率、潮气量分为A、B组。A组22例(呼吸频率12次/min,潮气量9 ml/kg),B组20例(呼吸频率14次/min,潮气量7 ml/kg),分别于气腹前(T1)、气腹后20 min(T2)、气腹结束后20 min(T3)监测气道压力峰值(PPEAK)、呼气末CO_2分压(PETCO_2)及p Hi值。结果 A、B两组在PPEAK、PETCO_2及p Hi参数方面各组组间T2同节点比较,差异有统计学意义[(分别为(25.68±2.61)mm Hg,(22.03±4.12)mm Hg;t=3.46,P<0.05;(35.68±1.61)mm Hg,(33.09±1.12)mm Hg;t=5.99,P<0.05;(7.08±0.08)mm Hg,(7.26±0.05)mm Hg;t=8.64,P<0.05]。结论使用适当的高通气频率、低潮气量通气方法,对CO_2气腹腹腔镜胆囊切除老年患者的呼吸功能及胃黏膜p H值具有正向作用。Objective To study the effects of repiratory frequency and tidal volume for CO2 pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy.Methods Forty-two patients were divided into group A（f=12,Vt =9 ml/kg,n =22）and group B（f=14,Vt=7 ml/kg,n=20）.PPEAK,PETCO2 and pHi were monitored before pneumoperitoneum （T1）20 min after pneumoperitoneum （T2）and relieving pneumoperitoneum （T3）respectively.Results PPEAK,PETCO2 at T2 were significantly higher than that at T1 in the same groups （P＆lt;0.05）.pHi of B group at T2 was significantly lower than that at T1（P＆lt;0.05）.There were significant difference of T2 indexes in group A compared with group B（P＆lt;0.05 ）.Conclusion The method of proper frequency rate and tidal volume in CO2 pneumoperitoneum may act positively for respiratory system and pHi of aged patients during laparoscopic cholecystectomy .

关 键 词：胃黏膜 氢离子浓度 老年患者 气腹 人工 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]