胆囊切除术_腹腔镜;脉搏血氧饱和度;监测_

腹腔镜胆囊切除术CO2气腹对脉搏血氧饱和度的影响

http://www.100md.com 《腹腔镜外科杂志》 2006年第6期

胆囊切除术,腹腔镜;脉搏血氧饱和度;监测,,胆囊切除术,腹腔镜;脉搏血氧饱和度;监测,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：观察腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)CO2气腹对脉搏血氧饱和度的影响。方法：按照美国麻醉医师协会体格情况分级(ASA)标准，选择ASAⅠ～Ⅱ级600例患者全麻下行LC，在围手术期对脉搏血氧饱和度(SpO2)进行连续监测。结果：CO2充气后3min SpO2明显下降(P<0.01)，放气后恢复到术前水平。结论:CO2气腹对脉搏血氧饱和度存在一定程度的影响，因此CO2气腹压力不宜过大，应限制在10～ 12mm Hg为宜，对老年患者伴有心、肺功能不全及肥胖者更要加强麻醉管理，加强SpO2、呼气末二氧化碳分压(PETCO2)监测。

    【关键词】胆囊切除术,腹腔镜;脉搏血氧饱和度;监测

    The effect of CO2 pneumoperitoneum on SpO2 in laparoscopic cholecystectomy

    ZHANG Shangmin,DING Hui,SHU Zhan,et al.

    Dept.of Anesthesiology,the Second People's Hospital of Shanxi,Xi'an 710005,China

    【Abstract】 Objective:To observe the effect of CO2 pneumoperitoneum on SpO2 in laparoscopic cholecystectomy.Methods:According to American Society of Anesthesiologists (ASA) Physical Status (PS) Classification,we selected 600 patients with ASAⅠⅡ and monitored their SpO2 continuously during operation.Results:SpO2 dropped significantly (P<0.01) three minutes after CO2 insufflation during LC.SpO2 recovered to preoperative level after release of CO2.Conclusions:The abdominal pressure should be restricted to the range of 1012mm Hg.For elderly patients with cardiac or pulmonary insufficiency and obses patients,more attention should be paid to SpO2 and PETCO2 should be continuously monitored. ......

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