人工CO2气腹对新生儿内环境的影响  

Effects of artificial CO2 pneumoperitoneum on neonatal internal environment

作　　者：刘红霞[1] 邓杰 卢文青[1] 肖煜[1] 李霄[1] 陈丽萍[1] 江英[1] LIU Hongxia;DENG Jie;LU Wenqing(Department of Neonatology,Jiangxi Children's Hospital,Nanchang,330006,China)

机构地区：[1]江西省儿童医院新生儿科

出　　处：《江西医药》2019年第10期1161-1163,共3页Jiangxi Medical Journal

基　　金：江西省卫计委科技计划课题，编号20175481

摘　　要：目的探讨新生儿腹腔镜手术中人工CO2气腹对患儿内环境的影响。方法收集2016年6月-2018年12月新生儿外科十二指肠梗阻行腹腔镜手术的新生儿42例,分别于人工CO2气腹建立前5min(T0)、气腹建立后20min(T1)、放气后20min(T2),采取动脉血样进行血气分析,记录各时点PaCO2、PaO2、pH、SaO2、SBE、Na+、K+、iCa2+的数值,并进行比较分析。结果T1与T0比较,PaCO2明显升高,pH有下降,差异均有统计学意义(P<0.05),T2与T0比较,PaCO2及pH均有轻度升高,但差异均无统计学意义(P>0.05);PaO2、SaO2、SBE、Na+、K+、iCa2+在T1、T0、T2时比较均无明显差异(P>0.05)。结论新生儿腹腔镜手术人工CO2气腹建立后可引起新生儿一过性的高碳酸血症,但放气后可恢复正常,无明显低氧血症,对电解质钠、钾、钙无明显影响,提示新生儿腹腔镜手术时患儿内环境相对稳定。Objective To investigate the effect of artificial CO2 pneumoperitoneum on the internal environment of neonatal laparoscopic surgery. Methods A total of 42 neonates underwent laparoscopic surgery for neonatal surgical duodenal obstruction from June 2016 to December 2018. In the first 5 min (T0) of artificial CO2 pneumoperitoneum, 20 min (T1) after artificial CO2 pneumoperitoneum and 20 min (T2) after deflation, arterial blood samples were taken for blood gas analysis, and PaCO2, PaO2, pH, and time points were recorded. The values of SaO2, SBE, Na+, K+, and iCa2+ were compared and analyzed. Results PaCO2 increased significantly and pH decreased when compared with T1 in T0 ,and the differences were statistically significant (P<0.05),PaCO2 and pH are slightly increased when compared with T2 in T0,but the differences were not statistically significant (P>0.05).There were no significant differences in PaO2, SaO2, SBE, Na+, K+ and iCa2+ at T1, T0 and T2 (P>0.05). Conclusion Neonatal laparoscopic surgery can cause neonatal transient hypercapnia after establishment of artificial CO2 pneumoperitoneum, but it can return to normal after deflation, no obvious hypoxemia, no significant effect on electrolyte sodium, potassium and calcium. It is suggested that the internal environment of neonatal laparoscopic surgery is relatively stable.

关 键 词：CO2气腹 新生儿 内环境 

分 类 号：R726.1[医药卫生—儿科]