气腹对七氟醚肺摄取的影响  

Pneumoperitoneum Impact on Lung Uptake of Sevoflurane

作　　者：王玲玲[1] 王菲[2] 纪凡层[3] 王伟芝[3] 

机构地区：[1]潍坊医学院麻醉学教研室,山东潍坊261053 [2]宁夏医科大学 [3]潍坊市人民医院麻醉科

出　　处：《潍坊医学院学报》2014年第6期473-475,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨妇科腹腔镜手术中人工气腹对七氟醚吸入麻醉肺摄取的影响。方法拟择期在全身麻醉下行全子宫切除术的患者40例,根据手术方式的不同分为两组(n=20):腹腔镜组(A组)和开腹组(B组),分别于吸入麻醉后5min(T1),15min(T2),30min(T3)及停止吸入麻醉前(T4),监测记录七氟醚吸入浓度(Fi)和呼出浓度(Et)、脑电双频指数(BIS)、气道峰压(Ppeak)、血压(BP)、心率(HR)、呼气末CO2分压(PET CO2)、动脉血CO2分压(PaCO2),根据Et,Fi计算Et/Fi比值。结果两组间的血压、心率、BIS比较无明显差异(P>0.05),A组的气道峰压高于B组(P<0.05),A组的PETCO2、PaCO2高于B组(P<0.05),两组间的Fi比较无明显差异(P>0.05),A组Et低于B组(P<0.05),A组Et/Fi低于B组(P<0.05)。结论在妇科腹腔镜手术中人工气腹使七氟醚的摄取量增加,两组患者BIS反映的麻醉深度无明显差异。Objective To study the effect of artificial pneumoperitoneum in laparoscopic surgery on lung uptake of sevoflurane anesthesia.Methods Forty patients to be operated with hysterectomy under general anesthesia were selected, they were divided into two groups depending on surgical approach,laparoscopic group A（n=20） and laparotomy group B（n=20）.When sevoflurane was started,in-haled concentration（Fi） and exhaled concentrations（Et）,bispectral index（BIS）,peak airway pressure（Ppeak）,blood pressure（BP）,heart rate（HR）,end-tidal CO2 partial pressure（PETCO2） and arterial partial pressure of CO2（PaCO2） were monitored and recorded at five minutes （ T1 ） ,fifteen minutes（ T2 ） ,thirty minutes（ T3 ） ,and before the end of surgery to stop inhaling sevoflurane（ T4 ） and the Et /Fi was calculat-ed.Results The blood pressure,heart rate and BIS of the two groups had no statistical difference（P〉0.05）,the peak airway pressure of Pneumoperitoneum group was higher than that of the laparotomy group（P〈0.05）,end-tidal CO2 partial pressure and arterial partial pressure of CO2 of Pneumoperitoneum group were higher than those of the laparotomy group（P〈0.05）,there was no significant difference between Fi of the two groups（P〉0.05）,the Et and E/Fi of pneumoperitoneum group were lower than those in the laparotomy group（P〈0.05）.Con-clusion Artificial pneumoperitoneum in laparoscopic surgery can make patients intake much more sevoflurane,there is no significant differ-ence between the depth of anesthesia of the two groups reflected by BIS.

关 键 词：人工气腹 七氟醚 吸入麻醉 肺摄取 

分 类 号：R971.2[医药卫生—药品]