CAJ | 학술논문

目的探讨幼儿腹腔镜手术时预防高碳酸血症的方案.方法选择接受腹腔镜手术,体征约10kg左右患儿40例,随机将其分为A、B两组,设定使用相同的9mmHg气腹压力,A组改变呼吸通气参数提前进行麻醉干预,B组选择通常呼吸通气参数进行麻醉,观察末梢二氧化碳分压及心率改变,同时对比两组发生二氧化碳潴留的机率并记录两组相关数据.结果提前麻醉干预组术中血气二氧化碳分压、心率和呼末二氧化碳大致正常,而进行正常呼吸通气参数麻醉麻醉组血气二氧化碳分压、心率和呼末二氧化碳高于干预组(P＜0.05).结论腹腔镜手术对小儿的呼吸、循环及血气虽有较大影响,但通过改变呼吸通气参数提前进行麻醉干预,对预防高碳酸血症有积极意义.
목적 탐토유인복강경수술시예방고탄산혈증적방안.방법 선택접수복강경수술,체정약10kg좌우환인40례,수궤장기분위A、B량조,설정사용상동적9mmHg기복압력,A조개변호흡통기삼수제전진행마취간예,B조선택통상호흡통기삼수진행마취,관찰말소이양화탄분압급심솔개변,동시대비량조발생이양화탄저류적궤솔병기록량조상관수거.결과 제전마취간예조술중혈기이양화탄분압、심솔화호말이양화탄대치정상,이진행정상호흡통기삼수마취마취조혈기이양화탄분압、심솔화호말이양화탄고우간예조(P＜0.05).결론 복강경수술대소인적호흡、순배급혈기수유교대영향,단통과개변호흡통기삼수제전진행마취간예,대예방고탄산혈증유적겁의의.
Objective To explore the schemes for hypercarbia prevention during laparoscopic surgery for children. Methods 40 children weighing about 10 kg and undergoing laparoscopic surgery were randomly divided into groups A and B. The same 9mmHg pneumoperitoneum pressure was applied in the two groups. Anesthetic invention was performed beforehand with changed parameters for respiratory ventilation in group A; group B received anesthesia with routine parameters for ventilation. The changes in the peripheral carbon dioxide partial pressure and heart rate were observed. The rate of carbon dioxide retention was compared between the two groups. Results In intervention group, intraoperative anesthesia carbon dioxide partial pressure and heart rate were generally normal, but carbon dioxide partial pressure and heart rate was significantly higher in group B than in group A (P＜ 0.01). Conclusions Laparoscopic surgery has a greater impact on respiration, circulation, and blood-gas. It is of clinical significance for preventing hypercarbia by changing the parameters of respiratory ventilation for anesthetic intervention beforehand.