CO2气腹对婴幼儿腹腔镜手术呼吸管理的影响

目的 探讨CO2气腹对婴幼儿腔镜手术呼吸管理的影响.方法 收集北京军区总医院2009年1月-2011年5月1100例以七氟烷吸入复合静脉全身麻醉下完成腹腔镜手术的0～8岁婴幼儿资料.对比气腹前5min(基础值)与气腹10min、气腹20min、气腹后10min和术后10min的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)、气道压(Paw)、体温(T),记录相关并发症发生情况.结果 与基础值相比,气腹10min、气腹20min的HR、MAP、Paw、PETCO2均显著升高(P＜0.05),SpO2、T无显著变化(P＞0.05).结论 腹腔镜手术CO2气腹对婴幼儿的循环和呼吸有较大影响,但充分的术前准备,加强麻醉期的监测,同样可以安全的实施腹腔镜手术麻醉.

Effects of CO2 aeroperitonia on respiratory management of infants and young children under laparoscopic surgery

Objective The present study investigates the effects of CO2 aeroperitonia on the respiratory management of infants and young children under laparoscopic surgery.Methods The clinical data of 1100 infants and young children,aged 0 to 8 years,admitted to our hospital from January 2009 to May 2011,were collected.All patients under laparoscopic surgery received sevoflurane inhalation combined with intravenous anesthesia for induction and maintenance.The heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO2),end-tidal carbon dioxide partial pressure(PETCO2),airway pressure(Paw),and the temperature(T) at 5min before aeroperitonia(basic data) were compared with those at 10 and 20 min after aeroperitonia,10min after end of aeroperitonia,and 10min after operation,and related complicating diseases were recorded and compared.Results The HR,MAP,PETCO2,and Paw at 10 and 20min of aeroperitonia were significantly higher than the basic data(P<0.05),whereas SpO2 and T showed no significant changes(P>0.05).Conclusions CO2 aeroperitonia during laparoscopic operation had a considerable effect on the circulation and respiration in patients.A stable anesthesia for infants and young children may be performed during laparoscopic operation with comprehensive preoperative preparation and enhanced monitoring during anesthesia.