摘要
目的观察在腹腔镜下胆囊切除术二氧化碳(CO2)气腹过程中丙泊酚对胃黏膜pH值的影响。方法腹腔镜下胆囊切除术患者42例,随机分为两组:异氟醚组(A组)和异氟醚、丙泊酚静脉-吸入复合组(B组),每组21例。于气腹前(T1)、气腹开始后40 min(T2)、气腹结束后40 min(T3)分别测定并记录胃黏膜与动脉血CO2分压差[P(i-a)CO2]、胃黏膜pH(pHi)值。结果A、B两组T2时P(i-a)CO2均明显高于T1时,T3时P(i-a)CO2均显著降低(P<0.05)。与A组相比,B组于T2时P(i-a)CO2显著降低,pHi显著升高(P<0.05);与T1比较,两组T3时P(i-a)CO2和pHi基本恢复至T1水平。结论丙泊酚与异氟醚静吸复合麻醉有利于稳定CO2气腹过程中胃黏膜pH,可能对维持CO2气腹过程中胃黏膜的血流灌注起到一定的积极作用,从而有利于患者术后的恢复和减少术后并发症的发生。
Objective To study the influence of propoful under the two different general anesthetics （isoflurane inhalation and isoflurane-propofol intravenous-inhalation combined anesthesia ） on the gastric mucosa pH in laparoscopic cholecystectomy（LC） during CO2 aeroperitoneum . Methods Forty-two patients with LC surgery were randomly divided into two groups. The patients were anesthetized with isoflurane inhalation （A group） or isoflurane -propofol intravenous-inhalation （B group）, There were 21 patients in each group. The values of CO2 partial pressure difference between gastric mucosa and arterial blood , P（i-a）CO2,and pH of gastric mucosa, pHi, were recorded at T1 （ before aeroperitoneum ）, T2 （40 minutes after the beginning of aeroperitoneum ） and T3 （ 40 minutes after the end of aeroperitoneum）. Results P （i-a） CO2 at T2 was significantly higher than that at T1 and P（i-a） CO2 at T3 dropped significantly in both A group and B group（P 〈0.05） . P（i-a） CO/ at T2 in group B was significantly lower than that in group A, Phi at T2 was significantly higher ,and P（i-a） CO/significantly lower in group B than those in group A （ P 〈0.05 ）. The values of P（i-a） CO2 and pH at T3 almost returned to the level at T1. Conclusion Isoflurane-propofol intravenous-inhalation combined anesthesia is in favor of stabling the PH value of gastric mucosa during CO2 aeroperitoneum , It improves the blood perfusion of gastric mucosa and reduces the complications after the operations.
出处
《医药导报》
CAS
2007年第9期1004-1006,共3页
Herald of Medicine
