容许性高碳酸血症在输尿管软镜钬激光碎石术麻醉中的应用

Application of permissive hypercapnia during anaesthesia in holmium laser lithoclasty with flexible ureteroscope

目的研究容许性高碳酸血症在输尿管软镜钬激光碎石术麻醉中的应用。方法 30例输尿管软镜钬激光碎石术患者均采用气管内插管全麻,随机分两组。术中调控A组患者PaCO2≤45 mmHg,B组患者45mmHg<PaCO2<70 mmHg。记录两组患者术中HR、MAP、pH、PaCO2和PaO2值,以及术后气管导管拔管时间、定向力恢复时间。结果两组患者术中HR、MAP没有明显差别(P>0.05),术后气管导管拔管时间、定向力恢复时间亦无明显差别(P>0.05);两组患者术中pH和PaCO2差异有显著性(P<0.05),但两组患者各时间点PaO2组间比较没有明显差异(P>0.05)。结论在输尿管软镜钬激光碎石术的麻醉中,容许性高碳酸血症的运用是安全有效的。

[ Objective ] To research the application of permissive hypercapnia during anaesthesia in holmium laser lithoclasty with flexible ureteroscope. [ Methods ] Thirty patients scheduled for endotracheal intubation general anesthesia in holmium laser lithoclasty with flexible ureteroseope were randomly divided into tow groups. In group A, regulated PaCO2 in patients less than or equal to 45 mmHg during the surgery, and regulated PaCO2 in patients higher than 45 mmHg but less than 70 mmHg in group B. Then all patients＂ heat rate, mean arterial pressure, pH, PaCO2, PaOz were recordedduring the surgery; and the times of tracheal intubation and oriebtation recovery were recorded after the surgery. [ Results ] There were no statistically significant differences of heart rate, mean arterial pressure and the times of tracheal intubation and oriebtation recovery between the two groups （P 〉0.05）. There were statistically significant differences of pH and PaCO2 between the two groups （P 〈0.05）, but the differences of PaO2 at each time point were not significant between the two groups （P 〉0.05）. [ Conclusion] The permissive hypereapnia can be safe and effective during anaesthesia in holmium laser lithoclasty with flexible ureteroscope.