腹腔镜下胆囊切除气腹对呼吸和循环的影响

目的观察腹腔镜下胆囊切除术气腹对呼吸和循环的影响。方法选择择期50例年龄21～68岁,ASAⅠ～Ⅱ级,腹腔镜下结石性胆囊炎或胆囊息肉切除患者作为研究对象。所有患者采用气管内插管全身麻醉,自动气腹机充气,先慢后快,维持压力恒定于15mmHg。连续监测Paw、HR、SpO2、SBP、DBP、PETCO2。比较观察全身麻醉气管插管,快诱导气管插管,麻醉机控制呼吸,。结果与气腹前相比,气腹后HR、SBP、DBP、Vt、PETCO2和Paw均有显著改变,P<0.05。结论腹腔镜下胆囊切除时气腹对呼吸和循环有明显的影响,可致HR、SBP、DBP、PETCO2、Paw显著升高,以及Vt明显下降。

Objective To observe the effect of pneumoperitoneum on respiratory and circulation system during the laparoscopic cholecystectomy. Methods 50 cases of stone suffering from cholecystitis or gallbladder polyps, aged 21-68 years old, ASA graded I- Ⅱ were studied. All the patients were anesthetized with general anesthesia and intubation. The parameters of Paw, HR, SpO2, SBP, DBP, PETCO2 were monitored intra-operatively. The pneumoperitoneum was induced by automatic machine and the pressure was maintained at a constant level, 15 mm Hg. Results Compared with pre- pneumoperitoneum, the Paw, HR,SPO2 ,SBP,DBP,PETCO2 were significantly different from those of post-pneumoperltoneum, P 〈 0. 05. Conclusions The laparoscopic cholecystectomy under pneumoperitoneum have strong affect on the respiratory and circulation system, and can cause HR, SBP, DBP, PETCO2, Paw significantly increase, and Vt decrease.