腔镜甲状腺切除术二氧化碳对血气的影响

Effects on blood gas during endoscopic thyroidectomy with carbon dioxide insufflation

目的探讨腔镜甲状腺切除术二氧化碳对机体血气的影响。方法对比23例腔镜甲状腺切除术患者手术时二氧化碳充气前、充气后动脉血气与呼气末二氧化碳分压等变化情况。结果腔镜甲状腺切除术二氧化碳充气后,动脉血二氧化碳分压显著增高,pH值充气后出现下降,呼气末二氧化碳分压迅速升高(P<0.05),充气后60min趋于稳定。结论腔镜甲状腺切除术时二氧化碳可引起一定程度的碳酸血症,但可通过改变呼吸参数及自身调节机制改善。腔镜甲状腺手术安全可行,但要注意术中监测血气等循环呼吸参数。

[Objective] To access adverse effects on blood gas in endoscopic thyroidectomy by breast approach with carbon dioxide insufllation. [Methods] 23 patients underwent endoscopic thyroideetomy were reviewed. Arterial partial pressure of carbon dioxide, pH, heart rate, breathe rate and pressure end-tidal CO2 were measured at baseline, 0.5, 1, 2 and 3 hours after carbon dioxide instrfllation. [Results] The arterial CO2 pressure increased and pH decreased quickly after carbon dioxide instrfllation （P 〈0.05）, pressure end-tidal CO2 increased as well, 1 hour later all data tended to be stable. [Conclusion] Hyperearbia oeeurrs in endoscopic thyroideetomy after carbon dioxide instrfllation, it can be improved by change breathe data. Thus endoscopic thyroideetomy is a feasible and safe procedure, and it＇s necessary to observe blood gas level.