腹腔镜小儿疝气高位结扎术中不同二氧化碳气腹压力对小儿呼吸循环系统的影响  

Influence of Different Carbon Dioxide Pneumoperitoneum Pressure on Respiratory and Circulatory System of Children during Laparoscopic High Ligation of Hernia in Children

作　　者：梁壮军 钟成发 李润生 LIANG Zhuangjun;ZHONG Chengfa;LI Runsheng(Huazhou Second People’s Hospital,Huazhou 525141,China;不详)

机构地区：[1]化州市第二人民医院,广东化州525141 [2]化州市中医院

出　　处：《中外医学研究》2021年第16期150-152,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:基于腹腔镜小儿疝气高位结扎术,探究不同二氧化碳(CO_(2))气腹压力对小儿呼吸循环系统的影响。方法:选取2019年11月-2020年10月来本院行腹腔镜小儿疝气高位结扎术的100例患儿。按入院顺序将其分为Ⅰ组(50例)和Ⅱ组(50例)。其中Ⅰ组给予较低的CO_(2)气腹压力(8.0~10.0 mm Hg),Ⅱ组给予较高的CO_(2)气腹压力(10.1~12.0 mm Hg)。对比两组气腹建立前5 min(T_(0))、气腹建立后10 min(T_(1))、气腹解除后5 min(T_(2))的呼吸力学参数[呼气末二氧化碳分压(P_(ET)CO_(2))、气道阻力(Raw)、气道峰压(Ppeak)]、循环功能参数[心率(HR)、平均动脉压(MAP)]、血气参数[pH、动脉血二氧化碳分压(PaCO_(2))]。结果:T_(1)时,两组P_(ET)CO_(2)、Raw、Ppeak值均较T_(0)时上升(P<0.05);T_(2)时,Ⅰ组P_(ET)CO_(2)、Raw、Ppeak与T_(0)时比较差异无统计学意义(P>0.05)。T_(1)时,Ⅱ组HR、MAP及Ⅰ组MAP均较T_(0)时上升(P<0.05);Ⅰ组HR、MAP T_(2)时与T_(0)时比较差异无统计学意义(P>0.05),Ⅱ组HR、MAP高于T_(0)时(P<0.05)。T_(1)时,两组PaCO_(2)较T_(0)时上升,pH下降(P<0.05);T_(2)时,Ⅰ组pH与T_(0)时比较差异无统计学意义(P>0.05),Ⅰ组PaCO_(2)高于T_(0)时(P<0.05)。T_(1)、T_(2)时,Ⅰ组P_(ET)CO_(2)、Raw、Ppeak、HR、MAP、PaCO_(2)均低于Ⅱ组(P<0.05)。结论:腹腔镜小儿疝气高位结扎术中,CO_(2)气腹压力维持在8.0~10.0 mm Hg可以减少对小儿呼吸循环系统的影响。Objective:To investigate the influence of different amounts of carbon dioxide(CO_(2))pneumoperitoneum pressure on children’s respiratory and circulatory system based on laparoscopic high ligation of hernia in children.Method:A total of 100 children with laparoscopic high ligation of pediatric hernia in our hospital from November 2019 to October 2020 were selected.According to the admission order,they were divided into the groupⅠ(50 cases)and the groupⅡ(50 cases),the groupⅠwas given lower CO_(2) pneumoperitoneum pressure(8.0-10.0 mm Hg),and the groupⅡwas given higher CO_(2) pneumoperitoneum pressure(10.1-12.0 mm Hg).The respiratory mechanical parameters[end-tidal carbon dioxide partial pressure(PETCO_(2)),raw air way resistance(Raw),peak airway pressure(Ppeak)],circulating functional parameters[heart rate(HR),mean arterial pressure(MAP)]and blood gas parameters[pH,arterial partial pressure of carbon dioxide(PaCO_(2))]were compared between the two groups 5 min before pneumoperitoneum establishment(T_(0)),10 min after pneumoperitoneum establishment(T_(1)),and 5 min after pneumoperitoneum release(T_(2)).Result:At T_(1),the PETCO_(2),Raw,Ppeak of both groups were higher than those at T_(0)(P<0.05);there were no significant differences in PETCO_(2),Raw,Ppeak in the groupⅠat T_(2) and T_(1)(P>0.05).At T_(1),the HR,MAP in the groupⅡand MAP in the groupⅠwere higher than those at T_(0)(P<0.05);there were no significant differences in HR,MAP of groupⅠat T_(2) and T_(1)(P>0.05),the HR,MAP in the groupⅡwere higher than those at T_(0)(P<0.05).At T_(1),the PaCO_(2) of both groups were higher than those at T_(0) and pH were lower(P<0.05);there was no significant difference in the pH of the groupⅠat T_(0) and T_(2)(P>0.05),the PaCO_(2) in the groupⅠwas higher than that at T_(0)(P<0.05).At T_(1) and T_(2),the PETCO_(2),Raw,Ppeak,HR,MAP,PaCO_(2) in the groupⅠwere lower than those in the groupⅡ(P<0.05).Conclusion:During laparoscopic high ligation of hernia in children,the pressure of CO_(2) pneumoperitone

关 键 词：二氧化碳气腹 腹腔镜 小儿疝气高位结扎术 小儿呼吸循环系统 

分 类 号：R726.5[医药卫生—儿科]