全麻下妇科肿瘤腹腔镜手术患者血气变化的观察

The change of carbon dioxide pneumoperitoneum on the arterial blood gas of the patient which undergoing gynecological laparoscopic tumor resection under general anesthesia

目的观察妇科肿瘤患者腹腔镜手术期间二氧化碳气腹对患者动脉血气的影响。方法选择妇科肿瘤行腹腔镜手术的患者40例,ASAⅠ~Ⅱ级,没有心、肺、脑系统疾病,全部行静吸复合全身麻醉,于气腹前、气腹后头低臀高位20分钟分别采取桡动脉血进行血气分析。结果 p H气腹后20分钟较气腹前显著下降,（P〈0.05）;动脉血二氧化碳分压气腹后20分钟较气腹前显著性增加（P〈0.05）;剩余碱气腹后20分钟较气腹前显著下降,（P〈0.05）;血氧分压气腹后20分钟较气腹前无显著性变化（P=0.65）,HCO-3气腹后20分钟较气腹前无显著性变化（P=0.71）。结论妇科肿瘤患者腹腔镜手术期间,二氧化碳气腹对患者动脉血气变化产生一定影响,但变化在正常值范围内。

Objective To observe the change of carbon dioxide pneumoperitoneum on the arterial blood gas of the patient which undergoing gynecological laparoscopic tumor resection. Method 40 ASA gradeⅠ~IIpatients with gy-necologic tumor undergoing laparoscopic surgery without known cerebral or cardiovascular system disease were selected. All the patients were under general anesthesia. Arterial blood gas analysis were did before insufflation and 20 min after the insufflation in the Trendelenburg position. Result Compare to those before pneumoperitoneum, pH、BE were significantly lower after the insufflation（P〈0. 05）,PaCO2 was significantly higher 20 min after the insuffla-tion（P〈0. 05）. PaO2 was not statistically significantly 20 min after the insufflation（P=0. 65）. HCO-3 was not statis-tically significantly 20 min after the insufflation（P=0. 71）. Conclusion The CO2 pneumoperitoneum have some effect on the change of the arterial blood gas during the operation of gynecology laparoscopy,but the change was in the normal range.