二氧化碳气腹压力对心率、平均动脉压、血氧饱和度的影响及对策

Influence of Carbon Dioxide Pneumoperitoneum Pressure on Heart Rate, Average Arterial Pressure and Oxygen Saturation of Blood and Measures

目的 观察不同压力对心率、平均动脉压、血氧饱和度的影响。方法 将腹腔镜胆囊切除术患者 40例随机分为A组 (气腹压力为 1.3～ 1.9kPa) ,B组 (气腹压力为 2 .0～ 2 .5kPa)。结果 B组气腹后 2 0分钟各参数变化明显 ,与A组比较有显著差异 (P <0 .0 5 )。结论 腹腔镜胆囊切除术时 ,在一定范围内心率、平均动脉压和血氧饱和度的变化程度与二氧化碳气腹压成正比 ,术中适宜的气腹压力为 1.3～ 1.9kPa ,并加强术中监测 ,及时调节气腹压力 。

Objective To observe the influence of different pressures on heart rate, average arterial pressure and oxygen saturation of blood. Methods Cholecystectomy was done on 40 cases of patients, who were divided into two groups randomly. The pneumoperitoneum pressure of group A was 1.3～1.9 kPa, that of group B was 2.0～2.5 kPa. Results All parameters of group B changed obviously twenty minutes after pneumoperitoneum, comparing with that of group A, the difference is significant. Conclusions During cholecystectomy under obdominoscope, the changes of heart rate, average arterial pressure and oxygen saturation of blood are directly proportional to carbon dioxide pneumoperitoneum pressure. The proper pressure is 1.3～1.9 kPa. So we should intensify introperational surveillance, regulate pneumoperitoneum pressure and relieve pneumoperitoneum pressure in case of necessity.