引用本文:李明川,于建宏,李克忠.长时间气腹对全麻后肺萎陷的影响[J].中国临床新医学,2017,10(12):1139-1141.
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长时间气腹对全麻后肺萎陷的影响
李明川,于建宏,李克忠
264000 烟台,青岛大学医学院附属烟台毓璜顶医院麻醉科
摘要:
[摘要] 目的 观察腹腔镜胃癌根治术患者术中功能残气量(FRC)和动脉血气分析的变化,研究长时间气腹对全麻后肺萎陷的影响。方法 选择择期行腹腔镜胃癌根治术患者30例。分别于诱导气管插管后10 min(T0)和气腹后30 min(T1)、60 min(T2)、2 h(T3)、3 h(T4)抽取患者桡动脉血行血气分析,记录pH值、动脉血氧分压(PaO2)、动脉血气CO2分压(PaCO2);同时采用密闭式氦稀释法测量FRC。结果 与T0比较,T1、T2、T3时患者FRC明显降低(P<0.01);与T3比较,T4时患者FRC差异无统计学意义(P>0.01)。与T0比较,T1时PaO2差异无统计学意义(P>0.01),T2、T3时明显降低(P<0.01)。与T3比较,T4时患者PaO2差异无统计学意义(P>0.01)。结论 长时间气腹可加重全麻后肺萎陷,并导致PaO2降低。
关键词:  长时间  气腹  肺萎陷
DOI:10.3969/j.issn.1674-3806.2017.12.03
分类号:R 614
基金项目:山东省医药卫生科技发展计划项目(编号:2014WS0245)
Effect of CO2 pneumoperitoneum on atelectasis in patients during general anesthesia
LI Ming-chuan, YU Jian-hong, LI Ke-zhong
Department of Anesthesiology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Shandong 264000, China
Abstract:
[Abstract] Objective To study the effect of long-time pneumoperitoneum on atelectasis after general anesthesia by means of observating the changes of the functional residual capacity(FRC) and arterial blood gas in the patients undergoing laparoscopic radical gastrectomy for gastric cancer.Methods 30 patients undergoing laparoscopic radical gastrectomy for gastric cancer were collected and their arterial blood samples were taken 10 min after induction of anesthesia(T0), and 30 min(T1), 60 min(T2), 2 h(T3)and 3 h(T4) after pneumoperitoneum. The levels of potential of hydrogen(PH), alveolar oxygen partial pressure(PaO2) and arterial partial pressure of carbon dioxide(PaCO2) were recored and the level of FRC was detected by the closed-circuit helium dilution method.Results Compare with those at T0, the levels of FRC were significantly decreased at T1, T2 and T3P<0.01). There was no significant difference in the level of FRC between T3 and T4P>0.01). There was no significant difference in the level of PaO2 between T0 and T1P>0.01),while the levels of PaO2 were significantly decreased at T2 and T3P<0.01).Conclusion Long-time pneumoperitoneum can aggravate atelectasis after general anesthesia, which results in the decrease of PaO2.
Key words:  A long time  Pneumoperitoneum  Atelectasis