后腹腔镜CO_2气腹对患者血流动力学及血气的影响

目的探讨后腹腔镜手术CO2气腹对患者血流动力学及血气的影响。方法选择后腹腔镜手术患者60例,监测气腹前、气腹后30min、60min和放气后30min血流动力学和动脉血气的变化。结果气腹后30min、60min患者心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)均较气腹前有显著性差异(P<0.05)。气腹前与放气后心率、平均动脉压(MAP)、中心静脉压(CVP)比较无显著性差异(P>0.05)。气腹后30min、60min患者动脉血二氧化碳分压(PaCO2)较气腹前明显增加,pH明显下降(P<0.05)。动脉血氧分压(PaO2)气腹前后比较无显著性差异(P>0.05)。结论后腹腔镜CO2气腹对患者血流动力学和动脉血气有一定影响,术中需加强监测。

Objective To explore the influence of retroperitoneal CO2 insufflation on hemodynamics and arterial blood gas in retroperitoneoscopic surgery. Methods 60 cases undergoing selective retroperitoneoscopic urologic surgery were studied. Hemodynamics and arterial blood gas were measured at four points： time before retroperioneal CO2 insufflation, 30 and 60 minutes after retroperioneal insufflations, 30 minutes after exsufflation. Results Retroperitoneal insufflations resulted in a significant increase of HR, MAP and CVP（P0.05）, while no significant difference was found in HR, MAP and CVP between before insufflations and after exsufflation（P0.05）. PaCO2 was increased and pH decreased significantly（P0.05）. PaO2 was always stable number in all times（P0.05）. Conclusion Retroperitoneal CO2 insufflation produces some effects on the patient,s hemodynamics and arterial blood gas. Specical attention should be paid in the operation.