腹腔镜手术围麻醉期高P_(ET) CO_2并低SpO_2的危险因素探讨

Analysis of the risk factors for hypetrcapnia and hypoxemia of patients with laparoscopic operation in perianesthesia

目的分析腹腔镜手术围麻醉期高PETCO2并低SpO2的危险因素、探讨防治措施。方法回顾性调查该院2003年6月-2006年6月间500例腹腔镜CO2气腹手术患者的相关临床资料,对其影响因素先行单因素危险度分析,再行Logistic回归分析。结果高PETCO2并低SpO2患者22例（4.4%）。超重及肥胖、长期大量吸烟、气腹持续时间长、气腹压力高、并发皮下气肿、特殊体位及气管导管偏深为其危险因素。结论危险因素涉及面广,宜采取针对性的预防措施,对术中有CO2潴留、低氧趋势者早用PCV或PCV＋PEEP（2-5cmH2O）模式通气,有多种危险因素存在时要加强预判、处理措施及早介入。

Objective To explore the risk factors and the measures for prevention and treatment of hypereapnia and hypoxemia of patients with pneumoperitoneum in perianesthesia. Methods A retrospective study of 500 patients with laparoscopic operation performed during June 2003 to June 2006 was presented. The risk factor for hyperearbia and hypoxemia was studied with logistic regression analysis. Results Hypercapnia and hypoxemia in perianesthesia occurred in 22 cases （ 4. 4% ）. These risk factors were overweight and obesity, the long-term and mass smoking, prolonged pneumoperitoneum, high tension of pneumoperitoneum, pneumoderma, position especial and deep intubation. Conclusion The distribution of the risk factors is extensive. Integrative measures ought to be taken for its prevention and treatment.