腹腔镜与开腹胆囊切除术后肺功能和血气变化对比临床研究

Changes of lung function and arterial blood gas after laparoscopic cholecystectomy and open sugery

作者对２２例腹腔镜胆囊切除术（ＬＣ），１２例全麻开腹胆囊切除术患者术前、术后肺功能及动脉血气变化进行了分析。结果显示ＬＣ组术后肺功能各指标（包括ＶＣ、ＦＶＣ、ＦＥＶ１和ＦＥＦ２５％～７５％）下降率明显较开腹组低（Ｐ＞０．０１），而术后２４小时开腹组ＰａＣＯ２较ＬＣ组高（Ｐ＜０．０５）。结论为ＬＣ对肺功能影响小且恢复快，气腹状态下使用肌松和辅助正压呼吸可防止高碳酸血症。

Abstract:Postoperative changes of lung function and arterial blood gas were studied in 22 LC cases and 12 open surgeries performed on general anacsthesia. It was found that the decrease of VC, FVC, FEv1 and FEF(25%~75%) in LC cases was less serious than that in open surgery(P>0.01),while the level of PaCO2 measured 24 hours after the surgery was much higher in open surgery(P<0.05). The authors came to the conclusion that LC caused only minor effect on lung function which recovered soon after the procedure, and hypercapnia could be prevented by both assistant positive pressure breathing and musclc relaxant.