不同气腹压力对全麻下腹腔镜胆囊切除术呼吸循环功能及麻醉效果的影响  

Effect Comparison of Different Pneumoperitoneum Pressures on Respiratory and Circulatory Function and Anesthesia Effect of Laparoscopic Cholecystectomy under General Anesthesia

作　　者：张晓满 杨海宁[1] 田文扬 ZHANG Xiaoman;YANG Haining;TIAN Wenyang(Anesthesiology Department,Qidong City Traditional Chinese Medicine Hospital,Qidong,Jiangsu 226000)

机构地区：[1]启东市中医院麻醉科,江苏启东226000

出　　处：《智慧健康》2024年第34期30-32,39,共4页Smart Healthcare

摘　　要：目的探究对行全麻下腹腔镜胆囊切除术的患者采取不同气腹压力对呼吸循环功能及麻醉效果的影响。方法将本院2022年5月—2023年12月收治的90例行全麻下腹腔镜胆囊切除术患者依据气腹压力分为对照和观察两组,每组45例。对照组选择高气腹压力(13~15 mmHg),观察组选择低气腹压力(8~12 mmHg),比较两组手术各项指标、呼吸循环功能指标、不良反应发生率。结果观察组胃肠功能恢复时间、术后住院时间较短于对照组(P<0.05)。在气腹前10 min、气腹后20 min、放气后5 min时间点,两组患者心率(HR)、平均动脉血压(MAP)、呼吸末二氧化碳分压(PETCO_(2))均先升高后降低,其中在气腹后20 min时间点观察组PETCO_(2)低于对照组(P<0.05)。相较于对照组,观察组不良反应发生率更低(P<0.05)。结论对行全麻下腹腔镜胆囊切除术的患者采取低气腹压力,可实现较为显著麻醉效果,能够缩短胃肠功能恢复时间、术后住院时间,对呼吸循环系统影响较小,减少不良反应发生,值得推广。Objective To explore the effect of different pneumoperitoneum pressures on respiratory and circulatory function and anesthesia effect of patients with laparoscopic cholecystectomy under general anesthesia.Methods The paper divided 90 patients with laparoscopic cholecystectomy under general anesthesia in our hospital from May 2022 to December 2023 into two groups according to different pneumoperitoneum pressures:the control group and the observation group,with 45 cases in each group.High pneumoperitoneum pressure(13~15 mmHg)was chosen for the control group,while low pneumoperitoneum pressure(8~12 mmHg)for the observation group.Surgical indicators,respiratory and circulatory function indicators and incidence of adverse reactions were compared.Results Recovery time of gastrointestinal function and postoperative length of stay in the observation group was significantly shorter than the control group,with significant difference(P<0.05).The time points were 10 min before pneumoperitoneum,20 min after pneumoperitoneum and 5 min after venting,heart rate(HR),mean arterial blood pressure(MAP)and end tidal carbon dioxide partial pressure(PETCO_(2))of two groups increased first and then decreased.At time point of 20 minutes after pneumoperitoneum,the PETCO_(2) of the observation group was lower than the control group,difference was significant(P<0.05).Incidence of adverse reactions in the observation group was lower,with significant difference(P<0.05).Conclusion Low pneumoperitoneum pressure can achieve significant anesthetic effect for patients with laparoscopic cholecystectomy under general anesthesia,can shorten recovery time of gastrointestinal function and postoperative length of stay,with little effect on respiratory and circulatory system,can reduce incidence of adverse reactions,which is worthy of promotion.

关 键 词：不同气腹压力 全麻下腹腔镜胆囊切除术 呼吸循环功能 麻醉效果 

分 类 号：R61[医药卫生—外科学]