气腹手术中不同时段二氧化碳分压变化的临床研究

The study on the change of arterial partial pressure of carbon dioxide during laparoscopic operation

目的通过气腹手术呼气末二氧化碳分压(PetCO2)监测与动脉二氧化碳分压(PaCO2)对比。探讨气腹前后二者间的关系。方法选40例ASAⅠ～Ⅱ级腹腔镜胆囊摘除手术病人。插管后气腹前、气腹后15分钟、气腹后30分钟、放气后5分钟分别测PetCO2及PaCO2。结果与气腹前比较,气腹后15、30分钟,PetCO2,PaCO2随着时间的变化逐渐增高(P<0.01),两者分压差(Pa-etCO2)变化不显著(P>0.05)。放气后5分钟,PaCO2不降反升,Pa-etCO2显著增加(P<0.01)。结论气腹终止后PaCO2与PetCO2的相关性变化较大,CO2的监测,以PaCO2更有临床意义,并应警惕PaCO2继续上升的潜在危险。

Objective To observe the relationship between arterial partial pre ssure of carbon dioxide(PaCO2) and end expiratory partial pressure of carbon dio xide during laparoscopic cholecys-tectomy.Methods 40 patients ASA grade Ⅰ～Ⅱu ndergone laparoscopic cholecystectomy were selected. PaCO2 and PetCO2 were measu red before Pneumo peritoneum 15 min and 30 min after the pneumo-peritoneum, 5 m in after the deflation respectively. Results Before pneumo-peritoneum15 min and 30 min after the pneumo-peritonium,the PaCO2 and PetCO2 were increased gradual ly during the operation.The differences between the two monitor indexes weren′t obvious(P >0 05).But 5 min after the deflation,PaCO2 and Pa-etCO2 were increa sed obviously(P< 0 01).Conclusion The relationship between PaCO2 and PetCO2 cha nges greatly 5 min after the deflation.The continual increase of PaCO2 may be da ngerous.