【作者】 梁枫；

【导师】 赵国庆；

【作者基本信息】 吉林大学 ， 临床医学， 2009， 硕士

【摘要】 目的:研究腹腔镜胆囊切除术二氧化碳气腹对肥胖患者呼吸和循环功能的影响。方法:选择ASAI-II级,手术时间1-2小时,择期在全身麻醉下行腹腔镜胆囊切除术(LC)的手术病人22例,又按体重指数的不同各分为两小组:A组为对照组,体重指数(BMI)=22±3,B组为肥胖组BMI=35±4。两组均记录气腹前(T0)、气腹后5min(T1)、气腹后15min(T2)及气腹后30min(T3)各时点的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(Sp02)、呼气末二氧化碳分压(PetC02),气道峰压(Paw)。所有数据均以均数±标准差(x±S)表示,应用SPSS统计学软件作统计学处理,组内数据比较采用配对t检验,组问数据比较采用Student t检验,P<0.01或<0.05为差异有显著性。结果: A和B两组在建立气腹前后及气腹不同时间点,HR、SBP、DBP和PetCO2,Peak较气腹前明显增高(P<0.01)。结论:应密切关注肥胖患者进行腹腔镜胆囊切除术气腹对呼吸循环的影响更多还原

【Abstract】 Objective To research the effect of pneumoperitoneum on respiratory and circulation system of the obesity during laparoscopic cholecystectomy.Methods 22 patients who received elective laparoscopic cholecystectomy were divided into 2 groups according to the BMI:control group (group A):BMI =22±3; obesity group (group B): BMI BMI=35±4 .All patients were ASA physical status I or II, non-smokers, and free of cardiac,pulmonary, renal or neuromuscular disease. The HR, SBP, DBP, PETC02, PAW, SPO2 of group A and group B were analyzed at the different time: before insufflation, 5 min after insufflation, 15 min after operation,30 min after operation.Data are means±SD. Effects of weight and abdominal insufflation were analyzed by repeated measures analysis of variance. And then we can described polyline maps.Results Pneumoperitoneum caused a significant lncrease in HR、SBP、Peak and PetC02 (P<0.01) in morbidly obese patients or in the normal. Peak was higher in morbidly obese compared with normal·weight patients before or during pneumoperitoneum, either undergoing laparoscopic cholecystectomy or laparoscopie gynecologic operation (P<0.05).Conclusion Morbidly obesity and pneumoperitoneum have significant effects on respiratory mechanics. C02 pneumoperitoneum of laparoscopic cholecystectomy results in more significant effects in respiratory and circulation system on obesity patients.更多还原