后腹膜腔镜手术CO_2气腹对全麻患者呼吸及循环的影响  

The Effect of Retroperitoneal Laparoscopic Surgery on the Respiration and Circulation during Gerneral Anesthesia

作　　者：万里[1] 张传汉[1] 吴舒华[2] 汤红[1] 王凤杰[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030 [2]武汉市儿童医院心内科,武汉430016

出　　处：《华中科技大学学报（医学版）》2002年第5期595-596,共2页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：为探讨后腹膜腔镜手术中气腹对全身麻醉患者血流动力学、呼吸及动脉血气的影响 ,选择了 4 0例 (ASA ～ )后腹膜腔镜下泌尿外科手术的患者 ,监测二氧化碳 (CO2 ) ,气腹前、气腹后 30 min、解除气腹后 30 min血压(Bp)、心率 (HR)、心电图 (ECG)、脉搏氧饱和度 (Sp O2 )及动脉血气、气道压力的变化。结果 :气腹前、后患者的血流动力学及气道压力变化不明显 (P>0 .0 5 ) ,动脉血气发生显著改变 ,出现高碳酸血症 (P<0 .0 5 )。研究表明 ,后腹膜腔镜手术 CO2 气腹对全身麻醉患者血流动力学、呼吸及血气产生一定的影响 。To observe the effect of retroperitoneal laparoscopic surgery on the respiratory and circulation, 40 patients (ASAⅠ Ⅱ) undergoing elective retroperitoneoscopic urological surgery were studied. Variables of hemodynamics and respiratory function, arterial blood gas analysis and airway pressure were recorded at three points, before and 30 min after CO 2 retroperitoneal insufflation, 30 min after withdrawal of CO 2 insufflation.The results showed that there was no significant difference in the hemodynamics and airway pressure ( P >0 05) during CO 2 retroperitoneal insufflation,but the PaCO 2 was increased and arterial pH decreased significantly ( P <0 05). It was indicated that retroperitoneal insufflation of CO 2 had effect on the patients' hemodynamics and respiratory function. Special attention should be paid to the management and monitor of the anesthesia.

关 键 词：后腹膜腔镜手术 麻醉 全身 血液动力学 人工气腹 

分 类 号：R656.5[医药卫生—外科学] R614.[医药卫生—临床医学]