不同通气模式对泌尿外科腹腔镜手术患者动脉血气及气道压的影响

代金贞; 陈堃; 李新华; 杨辉

不同通气模式对泌尿外科腹腔镜手术患者动脉血气及气道压的影响

- 华中科技大学同济医学院附属同济医院麻醉学教研室 430030

详细信息

通讯作者: 杨辉,E-mail:tjmzkyh@126.com

中图分类号: R572

收稿日期: 2012-02-22

Effect of different ventilation modes on artrial blood gas analysis and Paw in patients undergoing urologic laparoscopic surgery

- Department of Anesthesiology, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430030, China

More Information

Corresponding author: YANG Hui, E-mail: tjmzkyh@126.com

Received Date: 22 February 2012

摘要

摘要: 目的：观察泌尿腹腔镜手术中呼吸功能变化及增加每分钟通气量的两种方法的临床应用效果。方法：随机选择全麻下泌尿腹腔镜手术患者200例均分为A、B两组，男120例、女80例，年龄78~15岁。两组观察方法略同：气管内插管后，CO₂气腹前行动脉血气分析，同时记录PetCO₂、Paw。然后增加机械通气频率（A组2次/min、即每分钟通气量增加约16%，B组3次/min、即每分钟通气量增加约25%）。腹腔镜手术基本结束，终止CO₂气腹时，再次行动脉血气分析、同时记录PetCO₂、Paw。观察并比较两组CO₂气腹前后动脉血气、PetCO₂、Paw变化及差异。结果：两组患者气腹前pH、PaCO₂、PetCO₂及Paw比较差异无统计学意义。人工气腹后，两组患者均较气腹前pH降低， PaCO₂、PetCO₂和Paw升高，A组和B组相比，pH降低、PaCO₂、Paw升高，而PetCO₂无明显差异。结论：泌尿腹腔镜手术中的呼吸功能监测十分重要，不可忽视。为抵消CO₂气腹所导致的PaCO₂增加，选择每分钟通气量提高25%进行调节较为合适。
- 泌尿腹腔镜 /
- 动脉血气 /
- 气道阻力
Abstract: Objective: To abserve the effect of using different mechanical ventilation parameters on patients' respiratory function in Urologic Laparoscopic surgery. Method: Two hundred patients who underwent Urologic Laparoscopic surgery and general anesthesia were randomly in two group (group A and group B). Among them, there were 120 males and 80 females. Patients' age was range 18 to 70 years old. Patients in group A accept increase of respiratory rate 2 times per minute after artificial pneumoperitoneum, while the increase of respiratory rate in group B is three times. Patients' artrial blood were withdrawed before pneumoperitoneum and before termination of pneumoperitoneum to detact blood gas analysis and the PetCO₂ and Paw of patients were also record as same time. Result: After artificial pneumoperitoneum, All patients' (include group A and group B) pH(P<0.001) decreaded and PaCO₂, PetCO₂, Paw(P<0.001) increased. Results of blood gas anal indicated that patients in group B had more mornal pH, PaCO₂ (P<0.05)compare with group A.Conclusion: Monitoring of respritory function in patients who undergoing urologic laparosoic surgery is very important. As a result of our obeservaion, 25% increasing of minute ventilation(3 times increas of respiratory rate) can offset hypercapnia due to pneumoperitoneum.
- urologic laparoscopic surgery /
- artrial blood gas analysis /
- Paw

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参考文献(5)

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