腹腔镜胃癌根治术二氧化碳气腹对PaCO_2及PETCO_2的影响  

Effects of Carbon Dioxide Pneumoperitoneum on PaCO_2 and PETCO_2 during Laparoscopic-Assisted Radical Gastrectomy for Gastric Cancer

作　　者：邓莎[1] 陈建洪[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建泉州362000

出　　处：《南昌大学学报（医学版）》2014年第10期48-50,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的：探讨腹腔镜胃癌根治术二氧化碳（CO2）气腹对动脉血二氧化碳分压（PaCO2）及呼气末二氧化碳分压（PETCO2）的影响。方法择期全身麻醉下行腹腔镜胃癌根治术患者60例，分别在气腹开始前5 min（T0）、建立气腹后15 min（T1）、30 min（T2）、45 min（T3）及停气腹后5 min（T4）时采集动脉血测定 PaCO2及 PETCO2，计算PaCO2与 PETCO2的差值（Pa-ETCO2）和 Pa-ETCO2与 PaCO2的比值（Pa-ETCO2／PaCO2）。结果60例患者手术时间为175～285（227．8±42．6）min，气腹时间为121～158（136．3±11．8）min。T0时 PaCO2、PETCO2、Pa-ET-CO2和 Pa-ETCO2／PaCO2变化与 T1比较差异均无统计学意义（均 P ＞0．05）。T2、T3时患者 PaCO2、PETCO2、Pa-ETCO2和 Pa-ETCO2／PaCO2明显高于 T0和 T1（均 P ＜0．05）。T4时患者的 PaCO2和 PETCO2较 T2、T3明显降低，Pa-ETCO2和 Pa-ETCO2／PaCO2较 T2、T3明显升高（均 P ＜0．05）。结论腹腔镜胃癌根治术中 PETCO2不能准确反映 PaCO2，且两者差异随 CO2气腹时间的延长而扩大。Objective To investigate the effects of carbon dioxide pneumoperitoneum on arteri-al partial pressure of carbon dioxide（PaCO2 ）and partial pressure of end-tidal carbon dioxide （PETCO2 ）during laparoscopic-assisted radical gastrectomy for gastric cancer.Methods Arterial blood samples were obtained 5 minutes before the creation of pneumoperitoneum（T0 ）,15（T1 ）,30 （T2 ）and 45 minutes（T3 ）after the creation of pneumoperitoneum,and 5 minutes after the end of pneumoperitoneum（T4 ）for the determination of PaCO2 and PETCO2 in 60 patients undergoing e-lective laparoscopic-assisted radical gastrectomy for gastric cancer.The PaCO2-PETCO2 （Pa-ET-CO2 ）difference and Pa-ETCO2/PaCO2 ratio were calculated.Results The operation time was 175-285（227.8 ± 42.6）minutes.The pneumoperitoneum time was 121-158（136.3 ± 11.8）mi-nutes.There were no differences in PaCO2 ,PETCO2 ,Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio between T0 and T1 （P 〉 0.05）.Compared with T0 and T1 ,PaCO2 ,PETCO2 ,Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio increased at T2 and T3 （P 〈0.05）.Compared with T2 and T3 ,PaCO2 and PETCO2 decreased but Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio increased at T4 （P 〈0.05）.Conclusion PETCO2 can not accurately reflect the PaCO2 during laparoscopic-assisted radical gastrectomy for gastric cancer,and Pa-ETCO2 difference increases with the exten-sion of pneumoperitoneum time.

关 键 词：气腹 动脉血二氧化碳分压 呼气末二氧化碳分压 腹腔镜胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤] R614.1[医药卫生—临床医学]