二氧化碳气腹对老年胆石症病人心血管系统影响的临床研究

目的:探讨腹腔镜手术CO2气腹对老年胆石症病人心血管系统的影响,以减少和预防并发症,提高腹腔镜手术的安全性.方法:选择60例老年胆石症腹腔镜手术病人.观察CO2气腹不同阶段心率、血压、血氧饱和度、心电图、心肌酶谱的变化,分析其临床意义及预防对策.结果:建立CO2气腹时心率减慢、血压明显降低,气腹后30分钟心率加快、血压升高,心电图变化主要表现为心律失常(36%)及T波改变(30%),于气腹消退后10min恢复.心肌酶谱、血氧饱和度无明显改变.结论:CO2气腹过程中可引起一过性心率、血压、心电图的变化,对心功能异常的病人术中应进行严密心电监护,腹腔镜手术对老年胆石症病人是安全有效的治疗手段.

Clinical research of the effects of carbon dioxide pneumoperitoneum on cardiovascular function in geriatric cholelithiasis

Objective: To explore the effect of CO 2 pneumoperitoneum in laparoscopic surgery on the cardiovascular function of the geriatric cholelithiasis.Methods:Sixty aged patients undergone laparoscopic surgery were selected.During various stage of CO 2 insufflation,the heart rate(HR),blood pressure,oxygen saturation ,electrocardiogram(ECG),and myocardial enzymes were dected,and the clinical values of these changes were analyzed.Results: when CO 2 pneumoperitoneum established ,the HR and blood pressure were increased obviously .The incidence of arrhythmia was 36% and the incidence of changes of ST segment was 30%,10 minutes after pneumoperitoneum eliminated,these changes were restored. The myocardial enzymes and the oxygon saturation of blood had no distinct changes. Conclusion: The procedure of CO 2 pneumoperitoneum caused temporany changes of the HR ,SBP/DSP and ECG.The laparoscopic surgery is effective and safe for geriatric cholelithiasis.It suggests that the dynamic monitoring of electrocardiogram is necessary,especially for those with abnormal heart function.