CO2气腹对中老年直肠癌行腹腔镜手术患者呼吸和循环系统的影响

Influence of C02 Pneumoperitoneum on the Respiratory and Circulatory System of The Middle-aged and Elder- ly Undergoing Laparoscopic Surgery for Rectal Cancer

摘要为保证中老年直肠癌腹腔镜手术的安全，观测CO2气腹对呼吸和循环系统的影响，选择50例中老年择期行直肠癌腹腔镜手术患者，术中采用气管插管静脉复合结合连续硬膜外麻醉。行腹腔镜手术时，监测心率（HR）、平均动脉血压（MAP）、心电图（ECG）、呼吸频率（RR）、潮气量（VT）、气道压力（PAw）、血氧饱和度（SPO2）、呼气末二氧化碳分压（PetCO2）、动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）。结果显示，患者行CO2气腹前各项指标均在正常范围，CO2气腹后5min、15min的HR增快，MAP、PAw、PETCO2、PaCO2均升高。结果表明，CO2气腹对中老年直肠癌腹腔镜手术者呼吸、循环系统影响很大，因此，术中必须严密监测，备好抢救药品，对中老年合并心肺疾病者更应注意。

This study was to ensure the safety of the middle-aged and elderly undergoing laparoscopic sur- gery for rectal cancer, the influence of CO2 pneumoperitoneum on the respiratory and circulatory system was observed. Fifty middle-aged and elderly cases undergoing scheduled laparoscopic surgery for rectal cancer were selected. Tracheal intubation with intravenous anesthesia combined continous epidural anesthe- sia was intraoperatively performed. During operation, the patients were monitored from heart rate（HR）, mean arterial pressure（MAP）, electrocardiogram（ECG）, respiratory rate（RR）, tidal volume（VT）, positive airway pressure（PAw）,oxygen saturation（SPO2 ）, end-tidal carbon dioxide partial pressure（PETCO2）,arte- rial oxygen partial pressure （PaO2） and arterial partial pressure of carbon dioxide（PaCOe）. The results showed that all indicators were normal before performing CO2 pneumoperitoneum; 5-15 min after CO2 pneumoperitoneum, HR became faster, MAP, Paw, PET, CO2, PaO2 and PaCO2. increased. It is concluded that CO2 pneumoperitoneum has great impact on the respiratory and circulatory system of the middle-aged and elderly undergoing laparoscopic surgery for rectal cancer, therefore, patients should be closely moni- tored, rescue medications be ready, and special attention be given to the middle-aged and elderly with heart and lung disease.