腹腔镜胆囊切除术中CO_2气腹对呼吸的影响

The Effect of Pneumoperitoneum by CO_2 on Respiration during Laparoscopic Cholecystectomy

目的:观察腹腔镜胆囊切除术(LC术)中CO_2气腹对病人气道压、PetCO_2(呼吸末CO_2分压)及血气的影响。方法:全麻下腹腔镜胆囊切除术病人20例。于充气前充气,充血10、30min,放气后10min采动脉血,查血气。结果:充气15minPetCO_2、PaCO_2显著升高,P<0.01,pH下降,30minCO_2进一步升高,pH下降,放气后10min,CO_2仍高,结论:在LC手术中,应根据PetCO_2变化及时调整呼吸参数,防止术中、术后发生高碳酸血症。

Objective: To observe the effect of pneumoperitoneum by CO2 on pressure in airway, PetCO2 and arterial blood gas during laparoscopic cholecystectomy (LC). Method: Twenty cases were chosen to receive LC. The arterial blood was taken from them before inflation, 15( P < 0.05) and 30 (P < 0.01) min after inflation and 10min after deflation to analyse. Results:The saturations of PetCO2,PaCO2 and pressure in airway were increasing at 15 and 30min after inflation,pH was decreasing. 10min after deflations the saturation of PetCO2 and PaCO2 were still higher than that before inflation (P < 0.01) . Conclusion: The parameters of respiration should be adjusted according to variance of PetCO2 saturation in the patients during and after operation in order to prevent hypercapni-