摘要
目的 探讨全麻腹腔镜胆囊切除术 (LC)气腹后呼吸频率及潮气量的调控。 方法 ASAⅠ～Ⅱ成人患者 48例 ,随机分成 4组 ,全麻气管插管后机器控制呼吸 ,呼吸频率 10次 /min ,潮气量 10ml/kg ,气腹后Ⅰ组维持不变 ,Ⅱ、Ⅲ、Ⅳ组潮气量改为 8ml/kg ,呼吸频率分别为 14次 /min、16次 /min、18次 /min ,监测患者气腹前及气腹后 2 0min的平均动脉压 (MAP)、呼气末二氧化碳分压 (PETCO2 )、气道压力峰值 (PEAK)。 结果 Ⅰ组气腹后PETCO2 显著升高 ,显示有通气不足 ,同时MAP、PEAK均显著升高。Ⅳ组PETCO2 下降 ,显示有过度通气。Ⅱ、Ⅲ组PETCO2 正常。 结论 全麻腹腔镜胆囊切除术气腹后采用 8ml/kg的潮气量和 14～ 16次
Objective To study the better breath frequency and tidal volume after CO 2 pneumoperitoneum during laparoscopic cholecystectomy (LC) under general anaesthesia. Mehtod Fourtyeight cases of ASA grade Ⅰ～Ⅱwere randomly divided into four groups. After tracheal intubation, breath frequency was set at 10 time/min, tidal volume 10 ml/kg. After CO 2 pneumoperitoneum,the breath frequency and tidal volume of groupⅠwere the same while for group Ⅱ、Ⅲ、Ⅳ, they were adjusted to 14 time/min、16 time/min and 18 time/min respectively with tidal volume 8 ml/kg. The mean arterial pressure (MAP)、end tidal carbon dioxide partial pressure(P ETCO 2) and peak inflation pressure (PEAK) within 20 minutes before pneumoperitoneum and after pneumoperitoneum were monitored. Result In group Ⅰ, the P ETCO 2were significancely increased after CO 2 pneumoperitoneum which indicated insufficient ventilation. The MAP and PEAK were significantly increased at the same time. The P ETCO 2 of group Ⅳ descend, which indicated excessive ventilation. The P ETCO 2 of group Ⅱ、Ⅲ were normal. Conclusion It is better to adopt breath frequency 14～16 time/min and tidal volume 8 ml/kg after CO 2 pneumoperitoneum during LC under general anaesthesia.
出处
《中国现代手术学杂志》
2003年第3期200-201,共2页
Chinese Journal of Modern Operative Surgery
