气腹压力__(期刊论文)

不同CO2气腹压力对各年龄段患者手术期间呼吸系统参数的影响

http://www.100md.com 《腹腔镜外科杂志》 2005年第6期

气腹压力,,胆囊切除术，腹腔镜；CO2气腹；麻醉，全身；呼吸功能试验,1资料方法,2结果,参考文献：

     【摘要】目的：探讨腹腔镜胆囊切除术(LC)在不同CO2气腹压力下对不同年龄段患者围手术期呼吸系统各参数的影响。方法：择期行腹腔镜胆囊切除术90例。按年龄分为3组，20～40岁为中青年组，40～60岁为中老年组，>60岁为老年组，每组30例，各组按压力不同分A组(气腹压力8～12mm Hg)、B组(气腹压力14～16mm Hg)两组，每组15例，各组间性别，体重无统计学差别。观察各年龄段在不同气腹压力下各时点(气腹前10min、气腹后10、20、30min、放气后5min)呼吸系统参数(PETCO2、Paw、MVE、VCO2、VO2)的变化情况。结果：中青年组和中老年组：在A组、B组气腹注入后，呼吸系统各参数均有显著变化(P<0.01)，A、B两组间比较差异无显著性(P>0.05)。老年组：在A组、B组气腹注入后，呼吸系统各参数均有显著变化(P<0.01)。A、B两组间比较差异显著(P<0.01)。结论：(1)CO2气腹时间延长，会直接影响呼吸系统各参数的变化；(2)CO2气腹压力增加，会直接影响呼吸系统各参数的变化；(3)随时间延长气腹压力的变化对于中青年组、中老年组呼吸系统参数的影响差异无显著性，如果是健康机体，肺功能正常，手术可根据需要选用任一组气腹压力；(4)老年组气腹压力的变化随时间延长对呼吸系统各参数的影响差异显著。建议最好使用低气腹压力，以8~12mm Hg为宜。

    【关键词】胆囊切除术，腹腔镜；CO2气腹；麻醉，全身；呼吸功能试验

    The effects of LC on respireation system parameters of patients with different ages under defferent CO2 insufflation pressure during perioperative period

    GU Kuo,SUN Shibo

    1.Hospital of Dongbei Agriculture University,Haerbin 150030,China;2.The Second Hospital of Haerbin Medical University

    【Abstract】Objective:To investigate the effects of LC on rspireation system parameters of patients with different ages under different CO2 insufflation pressure duing perioperative period.Methods:Ninety patients were divided into 3 groups of 30.Each group was randomly divided into 2 subgroups of 15 according to different pressures:group A (insufflation pressure 812mm Hg),group B(insufflation pressure 1416mm Hg)to observe the chang of respication system parameters (PETCO2,Paw,MVE,VCO2,VO2) of patients with differen ages at the point of differen insufflation pressure (before insufflation 10min ,after insufflation 10,20,30min,after withdrawal of CO2 insufflation 5min).Results:Adult patients(2040y) and elder patients(4060y):after the input of insufflationsgroup A,group B,the respiration system parameters all changed dramatically(P<0.01) while there was no significant difference between group A and group B(P>0.05).Aged patients(>60y):after the input of insufflationsgroup A,group B,the respiration system parametes all changed dramatically(P<0.01)and there was significant difference between group A and group B(P<0.01).Conclusions:(1)CO2 insufflation lasting longer affects the change of respiration sysytem parameters diredtly;(2)CO2 insufflation pressure's increase affects the change of respiration system parameters directly;(3)The change of insufflation pressure has little influence on respiration system parameters for adult patients(2040y),elderly patients(4060y)with time lasting loger any group of insufflation pressure can be applied for a healthy body with normal lung function in an operation;(4)As for aged group(>60y),the change of insufflation pressure has great influence on respiration system parameters.The use of insufflation with low pressure(812mm Hg)is suggested strongly. ......

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