CAJ | 학술논문

目的：研究呼吸频率及潮气量在腹腔镜胆囊切除中CO2气腹对老年患者呼吸功能及胃黏膜pH值（pHi）的影响。方法42例腹腔镜胆囊切除CO2气腹的老年患者（≥65岁），在全麻CO2气腹压力为13 mmHg（1 mmHg＝0．133 kPa），依术中呼吸频率、潮气量分为A、B组。A组22例（呼吸频率12次／min，潮气量9 ml／kg），B组20例（呼吸频率14次／min，潮气量7 ml／kg），分别于气腹前（T1）、气腹后20 min （T2）、气腹结束后20 min（T3）监测气道压力峰值（PPEAK）、呼气末CO2分压（PET CO2）及pHi值。结果 A、B两组在PPEAK、PET CO2及pHi参数方面各组组间T2同节点比较，差异有统计学意义[（分别为（25．68±2．61）mmHg，（22．03±4．12）mmHg；t ＝3．46，P ＜0．05；（35．68±1．61）mmHg，（33．09±1．12）mmHg；t ＝5．99，P ＜0．05；（7．08±0．08）mmHg，（7．26±0．05）mmHg；t ＝8．64，P ＜0．05]。结论使用适当的高通气频率、低潮气量通气方法，对CO2气腹腹腔镜胆囊切除老年患者的呼吸功能及胃黏膜pH值具有正向作用。
목적：연구호흡빈솔급조기량재복강경담낭절제중CO2기복대노년환자호흡공능급위점막pH치（pHi）적영향。방법42례복강경담낭절제CO2기복적노년환자（≥65세），재전마CO2기복압력위13 mmHg（1 mmHg＝0．133 kPa），의술중호흡빈솔、조기량분위A、B조。A조22례（호흡빈솔12차／min，조기량9 ml／kg），B조20례（호흡빈솔14차／min，조기량7 ml／kg），분별우기복전（T1）、기복후20 min （T2）、기복결속후20 min（T3）감측기도압력봉치（PPEAK）、호기말CO2분압（PET CO2）급pHi치。결과 A、B량조재PPEAK、PET CO2급pHi삼수방면각조조간T2동절점비교，차이유통계학의의[（분별위（25．68±2．61）mmHg，（22．03±4．12）mmHg；t ＝3．46，P ＜0．05；（35．68±1．61）mmHg，（33．09±1．12）mmHg；t ＝5．99，P ＜0．05；（7．08±0．08）mmHg，（7．26±0．05）mmHg；t ＝8．64，P ＜0．05]。결론사용괄당적고통기빈솔、저조기량통기방법，대CO2기복복강경담낭절제노년환자적호흡공능급위점막pH치구유정향작용。
Objective To study the effects of repiratory frequency and tidal volume for CO2 pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy.Methods Forty-two patients were divided into group A(f=12,Vt =9 ml/kg,n =22)and group B(f=14,Vt=7 ml/kg,n=20).PPEAK,PETCO2 and pHi were monitored before pneumoperitoneum (T1)20 min after pneumoperitoneum (T2)and relieving pneumoperitoneum (T3)respectively.Results PPEAK,PETCO2 at T2 were significantly higher than that at T1 in the same groups (P<0.05).pHi of B group at T2 was significantly lower than that at T1(P<0.05).There were significant difference of T2 indexes in group A compared with group B(P<0.05 ).Conclusion The method of proper frequency rate and tidal volume in CO2 pneumoperitoneum may act positively for respiratory system and pHi of aged patients during laparoscopic cholecystectomy .