腹腔镜胆囊切除术CO_2气腹对脉搏血氧饱和度的影响

The effect of CO_2 pneumoperitoneum on SpO_2 in laparoscopic cholecystectomy

目的：观察腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）CO2气腹对脉搏血氧饱和度的影响。方法：按照美国麻醉医师协会体格情况分级（ASA）标准，选择ASAⅠ～Ⅱ级600例患者全麻下行LC，在围手术期对脉搏血氧饱和度（SpO2）进行连续监测。结果：CO2充气后3min SpO2明显下降（P〈0．01），放气后恢复到术前水平。结论：CO2气腹对脉搏血氧饱和度存在一定程度的影响，因此CO2气腹压力不宜过大，应限制在10～12mmHg为宜，对老年患者伴有心、肺功能不全及肥胖者更要加强麻醉管理，加强SpO2、呼气末二氧化碳分压（PETCO2）监测。

Objective：To observe the effect of CO2 pneumoperitoneum on SpO2 in laparoscopic cholecystectomy. Methods：According to American Society of Anesthesiologists （ASA）Physical Status （PS） Classification, we selected 600 patients with ASA Ⅰ-Ⅱ and monitored their SpO2 continuously during operation. Results：SpO2 dropped significantly （P 〈 0.01 ） three minutes after CO2 insufflation during LC. SpO2 recovered to preoperative level after release of CO2. Conclusions：The abdominal pressure should be restricted to the range of 10-12mm Hg. For elderly patients with cardiac or pulmonary insufficiency and obses patients, more attention should be paid to SpO2 and PETC02 should be continuously monitored.