胆囊切除术中气腹对老年患者呼吸循环的影响

目的观察腹腔镜胆囊切除术中CO2气腹对老年患者呼吸循环的影响。方法 2010年8月—2011年2月在扬州大学医学院附属泰兴市人民医院行腹腔镜胆囊切除术的老年患者136例,全身麻醉插管后腹腔内注入CO21～2 L/min,维持气腹压力在8～12 mmHg,监测气腹前,气腹后5、15和30 min,放气后5、15 min患者的心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度(SpO2)、呼气末CO2(pet-CO2)和吸气峰压(Ppeak),部分患者检测中心静脉压(CVP)和动脉血气分析。结果患者在气腹后5、15和30 min的petCO2、Ppeak与气腹前相比明显增高,差异有统计学意义(P<0.01),HR、SBP、DBP和CVP升高(P<0.05);术中发生心律失常78.5%,多见室上性心动过速和室性早搏;CO2分压(PaCO2)在气腹后15、30 min较气腹前明显升高,差异有统计学意义(P<0.01);pH值下降(P<0.05);19.2%的患者放气后15 min pH值仍略偏酸性。结论 CO2气腹对老年人呼吸和循环系统干扰较大,麻醉及手术护士要采取有效干预措施,可使老年患者减少并发症的发生...

Effects of CO_2 pneumoperitoneum on circulation and respiration in elderly patients with laparoscopic cholecystectomy

Objective To observe the effects of CO2 pneumoperitoneum on circulation and respiration in elderly patients with laparoscopic cholecystectomy.Methods A total of 136 patients with laparoscopic cholecystectomy in our hospital were selected from August 2010 to February 2011.After anesthesia all the patients were given an injection of CO2 gas into abdominal cavity at a speed of 1-2 L/min to maintain the pneumoperitoneum pressure at 8-12 mmHg.The parameters,such as heart rate(HR),systolic blood pressure(SBP),dia...