CAJ | 학술논문

目的探讨新生儿及小婴儿腹腔镜手术适宜气腹压力与基本生理指标间的函数关系.方法 A组20例腹腔镜手术患儿,在气腹前,气腹压力5mmHg和10mmHg时,分别记录患儿腹围,心率(HR)、平均动脉压(MAP),血氧饱和度(SiO2),呼气末二氧化碳分压(PETC2).B组30例腹腔镜手术患儿,气腹压力由6 mmHg逐步增加,当PETCO2达到或超过50 mmHg时,记录上一气腹压力值,即为适宜该患儿的气腹压力.结果 A组:5 mmHg气腹压力可使腹腔容积增加约35％,且PETCO2均小于50 mmHg.10 mmHg气腹压仅可使腹腔容积再增加约11％.B组:实验得到的个体化气腹压力与身长、体重、年龄、Kaup指数均存在相关.经逐步回归法的多元线性回归,得到回归方程为气腹压力(mmHg)=3.926+1.468×体重(kg).结论该函数关系适于预判3个月以内且心肺功能基本正常患儿的适宜气腹压力,术中根据PETCO2监测可对气腹压做进一步调整.
목적 탐토신생인급소영인복강경수술괄의기복압력여기본생리지표간적함수관계.방법 A조20례복강경수술환인,재기복전,기복압력5mmHg화10mmHg시,분별기록환인복위,심솔(HR)、평균동맥압(MAP),혈양포화도(SiO2),호기말이양화탄분압(PETC2).B조30례복강경수술환인,기복압력유6 mmHg축보증가,당PETCO2체도혹초과50 mmHg시,기록상일기복압력치,즉위괄의해환인적기복압력.결과 A조:5 mmHg기복압력가사복강용적증가약35％,차PETCO2균소우50 mmHg.10 mmHg기복압부가사복강용적재증가약11％.B조:실험득도적개체화기복압력여신장、체중、년령、Kaup지수균존재상관.경축보회귀법적다원선성회귀,득도회귀방정위기복압력(mmHg)=3.926+1.468×체중(kg).결론 해함수관계괄우예판3개월이내차심폐공능기본정상환인적괄의기복압력,술중근거PETCO2감측가대기복압주진일보조정.
Objective To investigate the effects of CO2 pneumoperitoneum pressure with primary physiological indexes in neonates and younger infants undergoing laparoscopy.Methods Twenty patients(group A)undergoing laparoscopic surgery were monitored using abdominal circumference,heart rate (HR),Mean aterial pressure (MAP),oxygen saturation (SiO2),end tidal CO2 (PETCO2),before pneumoperitoneum.during pneumoperitoneum with pressure at 5 mmHg and 10 mmHg.In thirty other patients (group B) undergoing laparoscopic surgery,pneumoperitoneum pressurewas increased from 6 mmHg upwards until PETCO2 achieved or surpassed 50 mmHg,and this pressure was the patient's feasible pneumoperitoneum pressure.Results PETCO2 was usually lower than 50 mmHg when CO2 pneumoperitoneum pressure was 5 mmHg in group A.Abdominal cavity volume would be increased by 35％ when pneumoperitoneum pressure was 5 mmHg,while an extra 11％ abdominal cavity volume was achieved at 10 mmHg.Individual pneumoperitoneum pressurewascorrelated with height,weight,age and kaup indexin group B,the regression function was:pneumoperitoneum pressure =3.926 + 1.468 × weight,using multiple regression method.Conclusions The function was suitable for patients younger than three-month with normal cardiopulmonary function,and the pneumoperitoneum pressure should be adjusted accordingto PETCO2.