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目的　探讨肺功能障碍对腹腔镜胆囊切除术的影响。方法　 1995～ 2 0 0 3年 ,通过监测 114例肺功能障碍和 12 0例肺功能正常的病人围手术期肺功能指标 ,比较两者在行腹腔镜胆囊切除术前后肺功能的变化和肺部并发症的发生率。结果　肺功能障碍和肺功能正常病人手术期肺功能指标中呼气末二氧化碳分压 (PCO2 )、气道分压 (Ppeak)、动脉血二氧化碳分压 (PaCO2 )在腹腔镜手术CO2 气腹后较气腹前同指标均明显增高 ;肺和胸廓顺应性 (C)、动脉血酸碱值 (PH )均明显下降 ,差异存在显著性 (P <0 0 1)。手术后各项指标与气腹前比较差异无显著性。肺功能障碍病人术后并发症明显高于肺功能正常组。结论　轻度至中度肺功能障碍病人行腹腔镜胆囊切除术是可行的 ,但需加强围手术期监护。重度肺功能障碍病人手术需慎行

Effects of pulmonary dysfunction on laparoscopic cholecystectomy

ObjectiveTo evaluate the effects of pulmonary dysfunction on laparosco pic cholecystectomy. MethodsThe effects of pulmonar y function on lap aroscopic cholecystectomy and the incidence of postopertive pulmonary complicati ons were compared by examini ng perioperative pulmonary function parameters of 114 patients with abnormal pul monary function and 120 patients with normal pulmonary function. Results The end tidal carbon dioxide pressure(PCO 2 ),airway peak pressure(Ppeak),and a rterial carbon dioxide pressure(PaCO 2 )of patients with pulmonary dysfun ct ion and normal pulmonary function in laparoscopy during the peritoneal insufflat ions increased, whereas respiratory compliance(C) and pH value decreas ed as compared with preinsufflation value (P<0 01).After deflation of peritoneal cavity, the parameters recovered to preinsufflation level.Pulmonary complicatio ns incidence in patients with pulmonary dysfunction was much higher than those with norma l pulmonary function. ConclusionLaparoscopic cholecystectomy i n patients with m ild or moderate pulmonary dysfunction is safe, but perioperative monitoring shou ld be intensified.Severe pulmonary function must be carefully treated.