【摘要】 目的观察腹腔镜胆囊切除术(LC)中二氧化碳气腹对患者心肺的影响。方法选择100例ASAⅠ-Ⅱ级胆囊结石或胆囊息肉择期行LC的患者,术前30min肌注鲁米那钠0.1g和海俄辛0.3mg,入室后连接Dash22000监护仪,麻醉诱导用药:仑芬太尼3μg/kg,咪达唑30μg/kg,乙咪酯0.3mg/kg,维库溴铵0.1mg/kg,术中以异丙酚维持,并间断吸安氟醚,监测并记录入室时、诱导前、插管后、气腹前、气腹后1,3,5,10min的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、血氧饱和度(SPO2)。结果病人诱导前的HR、血压、SPO2与入室时比较无明显变化(P>0.05),插管后SBP、MAP显著升高(P<0.01),SBP、DBP、MAP在气腹后1、3、5、10min都显著的升高,与入室时比较差异有显著性(P<0.05),但升高的幅度呈下降趋势。HR在整个麻醉过程中无明显变化(P>0.05)。SPO2在插管后显著上升(P<0.01)。结论腹腔镜胆囊切除术中二氧化碳气腹对循环和呼吸虽有一定的影响,但在全身麻醉下加强监测和管理,这种影响是可以减少或避免的。更多还原

【Abstract】 Objective To observe the effect of carbon dioxide pneumoperitoneum on the function of heart and lung in laparoscopic cholecystectomy.Methods fifty ASA ￠?-￠ò patients who underwent laparoscopic cholecystectomy at general anesthesia intravenously were enrolled into the study. All patients were infused phenobabital sodium 0.1g,hyosine 0.3mg, before entering operation room and connected to Dash22000 Multifunctional ECG after entering operation room . Fentanylum 3|ìg/kg,Midazolamum30|ìg/kg, Etomidate 0.3mg/kg,Norcuron 0. 1mg/kg , were used in anesthesia induction. Patients were administrated with propofol to maintain anesthesia and inhaled enflurane interruptablly. We monitored and recorded heart rates (HR), systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP),and saturation pulse O2 (SPO2) at 1 、3 、5 、10 min preinduction、postintubation、prepneumoperitoneum and postpneumoperitoneum.Results Patient s’ HR,BP,and SPO2 at preinduction were no obvious change when compared to values on entering operation room(P>0.05); SBP and MAP at postintubation were increased significantly (P<0.01), but extent of increase seemed to decrease; HR had no change during anesthesia; SPO2 at postintubation increased markedly (P<0.01).Conclusion Carbon dioxide pneumoperitoneum shows a certain effect on cardiovascular dynamics and lung function but as long as we carefully manage and monitor the general anesthesia, theeffect could be decreased or avoided.更多还原