| 摘要: |
| ［摘要］ 目的 探讨腹腔镜结直肠手术患者麻醉苏醒期二氧化碳（CO2）残留对术后苏醒质量的影响。方法 择期全身麻醉下行结直肠切除术患者200例，美国麻醉医师协会分级（ASA）Ⅰ～Ⅱ级，随机分为A组和B组，各100例。A组采用腹腔镜下行结直肠切除手术，B组采用开腹行结直肠切除手术。观察并记录两组患者拔管即刻（T1）、拔管后30 min(T2)、拔管后1 h（T3）、拔管后2 h（T4）、拔管后24 h（T5）、拔管后48 h（T6）各时间点的二氧化碳分压（PaCO2），并对T2～6各时间点作Steward苏醒评分、病人合作评分，同时记录两组患者的拔管时间、苏醒时间、麻醉恢复室停留时间以及拔管后高碳酸血症导致的相关并发症。结果 与T1时点比较，两组患者T2～5的PaCO2均增高，且A组T2～5 PaCO2显著高于B组（P<0.05）。B组病人合作评分在T2时点明显高于A组（P<0.05）。两组患者清醒时间、拔管时间比较差异无统计学意义（P>0.05）。A组的恢复室停留时间长于B组（P<0.01）。A组患高血压、恶心呕吐、烦躁的发生率明显高于B组（P<0.05）。结论 与开腹手术患者相比，腹腔镜结直肠手术患者术后吸收腹内残留的CO2明显影响患者麻醉后苏醒时间和苏醒质量，且增加了麻醉复苏期并发症发生率。 |
| 关键词: 腹腔镜 结直肠手术 二氧化碳残留 麻醉复苏 |
| DOI：10.3969/j.issn.1674-3806.2016.09.11 |
| 分类号:R 616.5 |
| 基金项目: |
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| The effects of carbon dioxide retention on the quality of recovery period of patients after laparoscopic colorectal surgery |
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RAN Xue-lian, CHEN Jun
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Department of Anesthesiology, the Second Hospital of Nanning, Guangxi 530031, China
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| Abstract: |
| ［Abstract］ Objective To observe the effects of carbon dioxide retention on the quality of recovery period of patients after laparoscopic colorectal surgery.Methods Two hundred patients undergoing laparoscopic colorectal surgery under general anesthesia, ASAⅠ～Ⅱ, were randomly divided into two groups, with 100 cases in each group. Group A received laparoscopic colorectal resection surgery, and group B received abdominal colorectal resection surgery. PaCO2 values were recorded at the time of extubation(T1), 30 min (T2), 1 hour (T3), 2 hours (T4), 24 hours (T5) and 48 hours (T6) after the extubation. Steward scores and the scores of the patients′ cooperation were assessed at the time points from T2 to T6. The extubation time, awake time, time of staying in the anesthesia recovery room and the complications that were related to hypercapnia after extubation were compared between the two groups.Results PaCO2 values at T2～5 in both of the two groups were increased compared with that at T1, and PaCO2 values of group A at T2～5 were significantly higher than those of group B(P<0.05). The patients′ cooperation scores of group B at T2 were significantly increased than those of group A(P<0.05). There were no significant differences in the awake time and extubation time between the two groups(P>0.05). The time of staying in the anesthesia recovery room in group A was significantly longer than that in group B(P<0.01). The incidences of hypertension, nausea, vomiting, restlessness in group A were significantly higher than those in group B(P<0.05).Conclusion The patients receiving laparoscopic colorectal surgery absorb the postoperative residual CO2 in their abdomens, which affects the patients′ anesthesia duration, awake time and the quality of anesthesia, and increases the incidence of complications during anesthesia recovery. |
| Key words: Laparoscopic Colorectal surgery Carbon dioxide retention Anesthesia recovery |
