不同气腹压力下婴幼儿腹腔镜手术中P_(ET)CO_2与PCO_2相关性研究

The study on the correlation between P_(ET)CO_2 and PCO_2 in different CO_2 pneumoperitoneum pressure in infants undergoiong laparoscopy

目的：探讨不同气腹压力下婴幼儿腹腔镜手术中PETCO2和PCO2的变化及相关性。方法：对36例拟行腹腔镜手术的婴幼儿按气腹压力不同随机分为3组；A组（气腹压力8mmHg）、B组（气腹压力10mmHg）和C组（气腹压力12mmHg），每组12例。于气腹前5min、气腹后10、30min以及放气后5min记录HR、MAP、SpO2、PETCO2，同时采集动脉血进行血气分析，记录PETTCO2值与PCO2值的对照，并计算Pa—ETCO2。结果：气腹后3组患儿HR、MAP均较前增高（P＜0．01），3组患儿PETCO2与PCO2均有良好相关性（P＜0．01），C组二者的相关性较A、B组减弱。结论；在腹腔镜气腹压力为8～12mmHg时，P盯CO2可取代PCO2，成为围术期重要的监测指标。

Objective： To explore the change and correlation of PETTCO2 and PCO2 in different CO2 pneumoperitoneum pressure in infants undergoiong laparoscopy. Methods： 36 infants scheduled for laparoscopic surgery were randomly divided into 3 groups, group A （pneumoperitoneum pressure 8mmHg）, group B （10mmHg） and group C （12mmHg）. HR, MAP, SpO2, PETCO2 and PCO2 were recorded 5 min before pneumoperitoneum, 10, 30 min after pneumoperitoneum and 5 min after deflation respectively. Pa-ETCO2 was calculated at the same time. Results, HR and MAP increased in 3 groups after pneumoperitoneum （P〈 0.01）. PETCO2 and PCO2 had correlation in 3 groups （P〈 0. 01） and the correlation in group A and B was better than that in group C. Conclusion, PETCO2 could replace PCO2 well when the pneumoperitoneum pressure is 8～12 mmHg during laparoscopic surgery.