低腹压腹腔镜胆囊切除术对呼吸、循环的影响

目的探讨应用低腹压CO2气腹行腹腔镜胆囊切除术时对呼吸、循环功能的影响.方法80例择期腹腔镜胆囊切除术患者,随机分为常规腹压组(2.0 kPa)40例,和低腹压组(1.6 kPa)40例,观察气腹前后气道压力(Paw)、二氧化碳分压(PETCO2)、血氧饱和度(SPO2)、平均动脉压(MAP)、心率(HR)的变化.结果气腹后15 min低腹压组上述指标均明显优于常规腹压组;但气腹前后比较,低腹压组Paw、HR仍有差别(P＜0.05).结论应用低腹压行腹腔镜胆囊切除术较常规腹压对心、肺功能的影响小,但术中仍需注意监测.

Influence of Low Pressure of Pneumoperitoneum on the Cardioresperatory Function during Laparoscopic Cholecystectomy

Objective To investigate the effects of low pressure value of pneumoperitoneum on the cardioresperatory function during laparoscopic cholecystectomy. Methods 80 patients qualified for laparoscopic cholecystectomy were randomised to either low pressure (LP=1.6 kPa) or standard pressure (SP = 2.0 kPa) pneumoperitoneum groups, 40 patients each.The indexes of Paw, P ET CO 2,SpO2, MAP and HR were measured before and after the creation of pneumoperitoneum. Results LP resulted in lower cardioresperatory activation than SP 15 min after pneumoperitoneum. Compared with the pre pneumoperitoneum ones, Paw and HR in LP group turned to be significantly different after pneumoperitoneum. Conclusions Comparison to SP, LP pneumoperitoneum with carbon dioxide results in significantly decreased cardioresperator activation during laparoscopy. But even in LP group, monitoring of the cardioresperatory function during operations is still necessary.