CO_2气腹对后腹腔镜手术患者血压、心率及CO_2排除量的影响

目的 观察CO_2气腹对接受后腹腔镜手术患者术中血压、心率(HR)及CO_2排除量的影响.方法 选取85例择期手术患者,其中后腹腔镜下行根治性肾癌切除手术患者(A组)45例,腹腔镜下行子宫全切或全子宫并双附件切除手术患者(B组)40例.监测并记录插管后气腹前(T_1)、气腹后15min(T_3)、气腹后30min(T_3)、气腹后45min(T_4)、气腹后60min(T_5)的HR、平均动脉压(MAP)、中心静脉压(CVP)、动脉血二氧化碳分压(PaCO_2)以及不同手术时段机体对CO_2的排除量.结果 与气腹前比较,两组患者在气腹后的各时段HR、MAP、CVP均明显增加(P<0.05),但两组间比较无显著性差异(P>0.05).与气腹前比较,两组PCO_2和CO_2排除量在气腹后的各时段均明显增加(P<0.05),且A组在T_4、T_5时段明显高于B组(P<0.05).结论 CO_2气腹对后腹腔镜与腹腔镜手术患者的血压、FIR等有一定的影响,但后腹腔镜手术比腹腔镜手术更容易引起高碳酸血症,术中需加强PaCO_2的监测.

Effects of CO_2 pneumoperitoneum on blood pressure,heart rate and depletion rate of CO_2 in the patients undergoing retroperitoneoscopic operation

Objective To observe the effects of CO2 pneumoperitoneum on blood pressure, heart rate (HR) and depletion rate of CO2 in patients undergoing retroperitoneoscopic operation. Methods Eighty-five patients undergone selective operation were involved in present study. Of them 45 underwent radical resection of kidney cancer with retroperitoneoscopy (group A), and 40 underwent laparoscopic hysterectomy or hysterectomy and removal of bilateral appendages (group B). The HR, mean arterial pressure (MAP), central veno...