腹腔镜胆囊切除术中PaCO_2和PetCO_2的变化及相关性

Change and correlation between PaCO_2 and PetCO_2 during laparoscopic cholecystectomy(LC)

目的探讨腹腔镜胆囊切除术(LC)中PaCO2和PetCO2的变化及相关性。方法选择A SAⅠ-Ⅱ级胆囊结石或胆囊息肉择期行腹腔镜胆囊切除术患者50例,于气腹前5 m in,气腹后5,15,25,35 m in和放气后5,10 m in采集动脉血标本行血气分析,同时记录相应时间的PetCO2,并求出Pa-etCO2。结果CO2气腹后15,25,35 m in,放气后5 m in,10 m in PaCO2,PetCO2,Pa-etCO2与气腹前比较均明显升高(P<0.01)。不同时间的PaCO2与PetCO2密切相关,呈显著的正相关(P<0.01)。而放气后5 m in,10m in Pa-etCO2则显著提高。结论在腹腔镜胆囊切除术麻醉过程中,PetCO2能较好的反映PaCO2压力变化,两者的相关性较好,但应注意气腹停止后,CO2继续吸收入血,导致PaCO2的升高。

Objective To investigate correlation between arterial partial pressure oi carbon dtoxtde（PaCO2）ano ena exptratory partial pressure of carbon dioxide（PetCO2）during laparoscopic eholecystectomy（LC）, Methods Fifty patients with ASA Ⅰ-Ⅱ who were to undergo LC were selected. PaCO2,PetCO2 were measured 5 min before pneumo-peritoneum,5,15,25,35 min after pneumo-peritoneum and 5,10 min after deflation respectively. Results PaCOz and PetCO2 15,25.35 rain after pneumo-peritoneum and 5,10 rain after deflation were significantly higher than those of 5 min before pneumo-peritoneum（P〈0.01）. Pa-et-CO2 after deflation increased obviously. Conclusion PetCO2 can replace PaCO2 well during LC. The relation between PetCO2 and PaCO2 is well correlated, But it should be noted that CO2 is absorbed into blood Continually and PaCO2 increases continually after deflation.