丙泊酚辅助麻醉下行腹腔镜手术气腹体位对呼吸及循环功能的影响

目的：探讨丙泊酚辅助麻醉下行腹腔镜手术气腹体位对呼吸及循环功能的影响。方法108例腹腔镜手术患者根据手术类型随机分为观察组与对照组，每组54例，两组患者采取不同体位进行手术治疗，采集两组患者气腹前（T0）、气腹后10min（T1）、体位改变后15min（T2）、体位改变后30min（T3）及撤除气腹并恢复体位10min （T4）时的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、血氧饱和度（SpO2）及PETCO2、气道峰压（Ppeak）并进行比较。结果 T1、T2、T3时点两组患者MAP、HR、Ppeak及PETCO2与T0期比较存在显著差异（P＜0.05），观察组T2、T3时点MAP、Ppeak、PETCO2明显高于对照组，T4时点观察组MAP及HR明显高于对照组（P＜0．05）。结论腹腔镜手术中体位是影响呼吸及循环功能的主要因素，应根据患者的实际病情及手术操作选择最为适宜的体位进行腹腔镜手术治疗。

The Effects of Pneumoperitoneum in Laparoscopic Operation on Respiratory and Circulatory Functions under Assisted Anesthesia by the Propofol

Objective to study the effects of pneumoperitoneum in laparoscopic operation on re-spiratory and circulatory functions under assisted anesthesia by the Propofol.Methods 108 cases by the laparoscopic operation were divided into observation group and control group according to the types of operation,54 cases in each group.The two groups were operated by the differ-ent position.We would collect and compare systolic blood pressure （ SBP ） , diastolic blood pressure （DBP）,mean arterial pressure （MAP）, blood oxygen saturation （SpO2）,PETCO2 and peak airway pressure （ Ppeak） before pneumoperitoneum （ T0 ） , 10min after pneumoperitone-um （ T1 ） , 15min after body position changes （ T2 ） , 30min after posture change （ T3 ） and 10min after withdrawal of pneumoperitoneum and recovery position （ T4 ） .Results There were signifi-cant differences for the MAP,HR,Ppeak and PET CO2 of the two groups between the stage of T1 ,T2 ,T3 and T0（ P〈0.05） .The MAP,Peak and PET CO2 of the observation group during the peri-od of T2 and T3 were significantly higher than those of the control group.The MAP and HR in the stage of T4 were significantly higher than those in the control group （ P〈0.05） .Conclusions The body posture during laparoscopic surgery is the main factor to affect the respiratory and circula-tory functions.The most suitable position should be chosen for laparoscopic surgery according to the actual circumstances.