CO2气腹对新生猪呼吸和循环功能的影响

Influence of carbon dioxide pneumoperitoneum on the circulatory and respiratory systems of piglets

目的建立新生猪气腹模型，观察CO2气腹中初生乳猪呼吸和循环功能相关指标的变化规律。方法乳猪共14头，年龄7～14d，体重2～4kg。分为2组：CO2气腹组7头，对照组7头。麻醉后监测心率、动脉压、中心静脉压、心输出量、每搏输出量，全身血管阻力、左心室内压变化速度、动脉血气。监测时间为麻醉稳定后手术开始前5min，手术开始后15min、60min、120min，关腹后60min。结果与对照组相比，实验组心率、全身血管阻力及左室内压变化速度增加，差异有统计学意义（P〈0．05）。与对照组相比较，气腹后心输出量、每搏输出量下降，差异有统计学意义（P〈0．05）。平均动脉压有升高趋势，但统计学意义不大。中心静脉压无明显变化。PaCO2增高（P〈0．05）、伴有pH下降，表现为轻度的呼吸性酸中毒，CO2气腹不引起新生猪血氧分压下降及血氧饱和度下降。结论健康乳猪在严密监测下可以耐受短时间气腹。

Objective To study changes of respiratory system and circulatory system of experimental pneumoperitoneum with carbon dioxide in piglets. Methods Fourteen piglets （2-4kg in weight, 7-14 days of age） were equally divided into the experimental group and the control group. After Fenta- nyl inhaled anesthesia, the pneumoperitoneum of experimental group was established by CO2. The con- trol group was made an abdominal incision 1 cm in length and sutured two hours later. The heart rate （HR）, arterial blood pressure （ALP）, central venous pressure （CVP）, stroke volume （SV）, cardiac output （CO）, systemic vascular resistance （SVR）, left ventricular dP/dT maximum （dPmx） and blood gases were measured. Timing of observation on experimental group was 5 min before carbon dioxide pneumoperitoneum, 15min,60min and 120 min after pneumoperitoneum formation and 60 min after deflation. Results Compared with the control group, HR, SVR and dPmx of experimental group increased after the beginning of pneumoperitoneum （P〈0. 05）, while SV and CO decreased （P〈0. 05）, and BP increased slightly but without statistical significance. There was no statistical alteration in CVP. In experimental group, the PaCO2 increased （P〈0. 05） and pH decreased with mild respiratory acidosis. There were no statistically significance changes of PaO2 and SaO2. Conclusions The experimental results suggest that healthy piglets can be tolerated CO2 pneumoperitoneum under general anesthesia and close monitor.