高原腹腔镜胆囊切除术中CO_2气腹对呼吸和循环功能的影响

Effect of CO_2 pneumoperitoneum on respiratory and circulatory function for patients with laparoscopic cholecystectomy in high altitude area

目的：观察高原地区腹腔镜胆囊切除术中CO2气腹对呼吸和循环功能的影响。方法：收治行腹腔镜胆囊切除术患者80例，ASAⅠ～Ⅱ级，所有患者均进行全身麻醉，观察并记录相应指标。结果：患者在气腹后5min、气腹后10min和气腹后20min时间点上平均动脉压(MAP)、收缩压(SBP)、平均气道压(Pmean)、舒张压(DBP)、气道峰压(Ppeak)和心率(HR)与气腹前5min比较，均显著增加。气腹后10min和20min与气腹前5min相比，PETCO2显著增加；气腹后20min与气腹后5min比较，呼吸末PETCO2显著增加，以上差异均具有统计学意义(P＜0.05)。结论：高原地区腹腔镜胆囊切除术中CO2气腹对呼吸和循环功能影响显著，但通过调节呼吸机参数可以减轻或者避免CO2气腹对呼吸和循环功能的影响。

Objective:To observe the effect of CO2 pneumoperitoneum on respiratory and circulatory function for patients with laparoscopic cholecystectomy in high altitude area.Methods:80 patients treated with laparoscopic cholecystectomy were selected,ASA Ⅰ～Ⅱ grade,and general anesthesia was performed in all patients.We observed and recorded the corresponding index.Results:The mean arterial pressure(MAP),systolic blood pressure(SBP),mean airway pressure(Pmean),diastolic blood pressure(DBP),peak airway pressure(Ppeak)and heart rate(HR)at the time point of 5 min,10 min,20 min after pneumoperitoneum were significantly increased compared with the 5 min before pneumoperitoneum.The PET CO2 after 10 min,20 min of pneumoperitoneum significantly increased compared with 5 min before pneumoperitoneum.20 min after pneumoperitoneumcom pared with 5 min after pneumoperitoneum,the PET CO2 increased significantly.The above differences were statistically significant(P < 0.05).Conclusion:The effect of CO2 pneumoperitoneum on respiratory and circulatory function is significant for patients with laparoscopic cholecystectomy in high altitude area,but by adjusting the ventilator parameters can avoid or reduce the effect of CO2 pneumoperitoneum on respiratory and circulatory function.