不同气腹压力下婴幼儿腹腔镜手术中P_(ET)CO_2与PCO_2相关性研究

目的探讨不同气腹压力下婴幼儿腹腔镜手术中PETCO2和PCO2的变化及相关性。方法对36例拟行腹腔镜手术的婴幼儿按气腹压力不同随机分为3组A组(气腹压力8mmHg)、B组(气腹压力10mmHg)和C组(气腹压力12mmHg),每组12例。于气腹前5min、气腹后10、30min以及放气后5min记录HR、MAP、SpO2、PETCO2,同时采集动脉血进行血气分析,记录PETCO2值与PCO2值的对照,并计算Pa-ETCO2。结果气腹后3组患儿HR、MAP均较前增高(P<0.01),3组患儿PETCO2与PCO2均有良好相关性(P<0.01),C组二者的相关性较A、B组减弱。结论在腹腔镜气腹压力为8~12mmHg时,PETCO2可取代PCO2,成为围术期重要的监测指标。

The study on the correlation between PETCO2 and PCO2 in differentCO2 pneumoperitoneum pressure in infants undergoiong laparoscopy

Objective: To explore the change and correlation of P_(ET)CO_2 and PCO_2 in different CO_2 pneumoperitoneum pressure in infants undergoiong laparoscopy. Methods: 36 infants scheduled for laparoscopic surgery were randomly divided into 3 groups: group A(pneumoperitoneum pressure 8mmHg), group B(10mmHg) and group C(12mmHg). HR, MAP, SpO_2, P_(ET)CO_2 and PCO_2 were recorded 5 min before pneumoperitoneum, 10, 30 min after pneumoperitoneum and 5 min after deflation respectively. Pa-ETCO_2 was calculated at the same time. Results: HR and MAP increased in 3 groups after pneumoperitoneum (P<0.01). P_(ET)CO_2 and PCO_2 had correlation in 3 groups(P<0.01) and the correlation in group A and B was better than that in group C. Conclusion: P_(ET)CO_2 could replace PCO_2 well when the pneumoperitoneum pressure is 8～12 mmHg during laparoscopic surgery.