比较人工腔隙与自然腔隙CO2气腹对血流动力学及动脉血气的影响

目的探讨人工腔隙腔镜下手术CO2气腹与自然腔隙腔镜下手术CO2气腹对血流动力学及动脉血气的影响。方法58例人工腔隙腔镜下手术的择期病人，45例自然腔隙腔镜下手术的择期病人：于CO2充气前、充气后15、30、45、60和90min分别观测并记录血压（BP），心率（HR），血氧饱和度（SpO2），呼吸末二氧化碳分压（PETCO2）等参数，并行动脉血气分析，观察其变化。结果充气后两组组内比较与充气前的BP、HR、PETCO2、PaCO2有显著性差异（P〈0．05）。充气后30min各指标组间比较无统计学差异（P〉0．05）。充气后45min及其后时间点，BP、HR组间比较无统计学差异（P〉0．05），PETCO2、PaCO2两组组间比较有统计学差异（P〈0．05）。结论两组充气后机体内PETCO2、PaCO2的变化大，30min后处于相对稳定，但人工腔隙组影响更大。

Effects of Carbon Dioxide Pneumoperitoneum by Means of Artificial Space or Natural Space on Hemodynamics and Arterial Blood Gas Analysis

Objective To discuss the effects of carbon dioxide pneumoperitoneum by means of artificial space or natural space on hemodynamics and arterial blood gas： Methods One-hurdred and three patients scheduled for elective laparoscopic surgery were included in this trial. The parameters, such as BP （ blood pressure） , HR （ heart rate） , SaO2 （ arterial oxygen saturation） PETCO2 （ pressure of end - tidal CO2 ） and so on, were recorded and analyzed before pneumoperitoneum and 15, 30, 45, 60 and 90 minutes after pneumoperitoneum, respectively in artificial space group （ n = 58 ） and natural space group （ n = 45 ）. Results In both the groups, BP, HR, PETCO2 and PaCO2 （ arterial partial pressure of CO2 ） increased slgnicantly after pneumoperitoneum when compared with that of pre - pneumoperitoneum （ P 〈 0.05 ） , while PETCO2 and PaCO2 were higher in the artificial space group than in the natural space group 40, 60 and 90 minutes after pneumoperitoneum （ P 〈 0.05 ）. Conclusion PETCO2 and PaCO2 change obviously after pneumoperitoneum and tend to be stable 30 minutes after pneumoperitoneum, but artificial space influence such indexes more.