不同麻醉方法对妇科腹腔镜手术二氧化碳蓄积的影响

Influence of Different Anesthesia on Carbon Dioxide Accumulation During Gynecological Laparoscopic Operation

目的:探讨不同麻醉方法对妇科腹腔镜手术患者呼吸二氧化碳的影响,寻求适宜的麻醉方式。方法:随机选择60例妇科腹腔镜择期手术患者,分成两组,每组30例,组1使用硬膜外复合静脉全麻,保留自主呼吸;组2使用气管插管静脉全麻,机械通气。分别观察并记录患者术前、气腹后10,30,60 min时收缩压(SBP),舒张压(DBP),心率(HR),呼气末二氧化碳分压(P_(ET)CO_2)等指标,并随访患者术后不良反应。结果:两组患者生命体征平稳,组1 P_(ET)CO_2明显高于组2(P,BP,HR,RR在观察点比较差异无显著性,P>0.05)。组1术中低血压、CO_2蓄积发生率明显高于组2(P<0.05),其余不良反应差异无显著性(P>0.05)。结论:气管插管静脉全麻更适用于妇科腹腔镜手术,尤其在控制患者二氧化碳蓄积方面明显优于硬膜外复合静脉全麻。

Objective ：To investigate the influence of different anesthesia on carbon dioxide accumulation during gynecological laparoscopic operation. Methods： 60 patients undergoing gynecological laparoscopic operation were divided into combined epidural with intravenous anesthesia group and general anesthesia with tracheal intubation group, SBP, DBP, HR and PET CO2 were monitored before aeroperitoneum and 10, 30,60 minutes after aeroperitoneum. Results： The patients＇ life condition were normal in two groups, PETCO2 of patient in group 1 was higher than that in group 2, the incidence of hypotension and carbon dioxide accumulation in group 1 was higher than that in group 2. Conclusion： General anesthesia with tracheal iutubation is more suitable for gynecological laparoscopic operation, especially for the control of carbon dioxide accumulation.