腹腔镜小儿腹股沟斜疝内环结扎术对循环及血气指标的影响

目的探讨腹腔镜小儿腹股沟斜疝内环结扎术的应用效果及对患儿血气指标的影响。 方法回顾性分析2017年3月至2018年6月,山东省聊城市人民医院腹股沟斜疝患儿49例,所有患儿均行腹腔镜下小儿腹股沟斜疝内环结扎术。比较患儿气腹前（T0）、气腹后10 min（T1）、气腹后30 min（T2）及放气后10 min（T3）循环及血气指标的改变。 结果与T0比较,T1～T3时患儿平均动脉压、收缩压、舒张压、每搏输出量循环指标水平均无明显变化（P>0.05）;T1～T2时心率明显加快（P<0.05）;T3时又恢复至T0水平（P>0.05）。与T0比较,T1、T2时患儿动脉血氧分压（PaO₂）及pH值均明显降低,动脉血二氧化碳分压（PaCO₂）明显升高（P均<0.05）,T3时PaO₂、PaCO₂及pH值均恢复至T0时水平（P>0.05）,T0～T3时间内患儿动脉血氧饱和度无明显变化（P>0.05）。 结论腹腔镜小儿腹股沟斜疝内环结扎术可在一定程度上影响患儿血气,但对循环系统并无明显影响,仅心率有轻微增快。

Application effect of laparoscopic interior loop ligation in children with indirect inguinal hernia and its effect on blood gas indexes in children

ObjectiveTo explore the clinical influence of laparoscopic internal loop ligation in children with indirect inguinal hernia and the effect on blood gas parameters of children. MethodsWe retrospectively analyzed 49 children with indirect inguinal hernia admitted to Liaocheng People's Hospital in Shandong Province between March 2017 and June 2018, all children underwent laparoscopic interior loop ligation. The changes of circulation and blood gas indexes between pre-pneumoperitoneum (T0), 10 min after pneumoperitoneum (T1), 30 min after pneumoperitoneum (T2) and 10 min after deflation (T3) were compared. ResultsCompared with T0, there was no significant change in the levels of mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP) and stroke volume (SV) in children from T1 to T3 (P>0.05), the heart rate (HR) significantly accelerated from T1 to T2 (P<0.05), and returned to T0 at T3 (P>0.05). Compared with T0, the PaO₂ and pH values of children at T1, T2 significantly decreased, PaCO₂ significantly increased (P<0.05 or P<0.01), and the levels of PaO₂, PaCO₂ and pH were restored to T0 at T3 (P>0.05), there was no significant change in SaO₂ from T0 to T3 (P>0.05). ConclusionLaparoscopic internal loop ligation in children with indirect inguinal hernia can affect the blood gas of children to a certain extent, but it has no significant effect on the circulatory system, only HR has a slight increase.