全麻诱导期呼气末正压通气对肥胖患者腹腔镜胆囊切除术后呼吸功能和肺不张的影响

Effect of PEEP on respiratory function and atelectasis in obese patient after laparoscopic cholecystectomy

目的：探讨针对腹腔镜胆囊切除术后肥胖患者进行全麻诱导期呼气末正压通气对其呼吸系统功能以及肺不张的影响。方法：选择2013年6月～2014年6月我院收治的拟行腹腔镜胆囊切除术的肥胖患者作为研究对象，随机等分为对照组和观察组，对照组患者于术中加用呼气末正压通气，观察组患者于麻醉诱导期开始便加用呼气末正压通气。两组患者的麻醉诱导期、维持期以及其他处理因素保持一致。比较两组患者血气变化情况。结果：与对照组比较，观察组气腹后1 h和拔管1 h 的PaO2和PaCO2差异有统计学意义（P〈0.05）。两组患者气腹后1 h和拔管后1 h的HR以及MAP数据（P〈0.05）。结论：针对腹腔镜胆囊切除术后肥胖患者进行全麻诱导期呼气末正压通气，可以有效预防接受全身麻醉术后患者可能发生的低氧以及高二氧化碳血症，有效控制肺不张发生，具有极大的推广应用价值。

Objective：To investigate the induction of PEEP affect their respiratory system anesthesia and atelectasis for obese patients after laparoscopic chol-ecystectomy. Methods：Chose June 2013-June 2014 in our hospital in obese patients undergoing laparoscopic cholecystectomy as research subjects were ran-domly divided into control group and observation group and the control group of patients in Surgery plus end-expiratory pressure ventilation in patients in the observation group will begin the induction of anesthesia plus PEEP. Induction of anesthesia,two groups of patients, the maintenance phase as well as oth-er processing factors remain the same. Changes in the blood of patients were compared. Results：Compared with the control group,1 h and extubation for 1 h PaO2 and PaCO2 observation group after pneumoperitoneum difference was statistically significant （P〈0. 05）. Two groups of patients after pneumoperitone-um 1 h and HR 1 h after extubation and MAP data （P〈0. 05）. Conclusion：Obese patients after laparoscopic cholecystectomy general anesthesia induction PEEP,can be effective in preventing patients receiving general anesthesia may occur hypoxia and hypercapnia,effective control of atelectasis,it has great ap-plication value.