CAJ | 학술논문

目的：观察病态肥胖患者腔镜胃旁路手术麻醉中动脉血二氧化碳分压（PaCO2）与呼吸末二氧化碳分压（Pet-CO2）的关系。方法观察40例BMI为35~50 kg/m2，在腔镜下行胃旁路手术的病态肥胖患者，记录在全麻插管后气腹前、气腹30 min，气腹60 min，气腹120 min，放气后30 min，放气后60 min等不同时间点PaCO2和Pet-CO2的值，比较PaCO2和Pet-CO2的值及其相关性。结果各时间点的Pet-CO2值均低于PaCO2值，在气腹前、气腹时和气腹放气后3种不同的机体状态下PaCO2和Pet-CO2呈密切正相关（P<0.05），在16 mmHg中等压力CO2气腹状态下，气腹后30、60、120 min 3个时间点PaCO2和Pet-CO2的相关性与气腹前、气腹放气后PaCO2和Pet-CO2的相关性的r值有差别。结论病态肥胖患者在中等CO2气腹压，腹腔镜辅助行胃旁路手术中PaCO2和Pet-CO2是密切相关的。
목적：관찰병태비반환자강경위방로수술마취중동맥혈이양화탄분압（PaCO2）여호흡말이양화탄분압（Pet-CO2）적관계。방법관찰40례BMI위35~50 kg/m2，재강경하행위방로수술적병태비반환자，기록재전마삽관후기복전、기복30 min，기복60 min，기복120 min，방기후30 min，방기후60 min등불동시간점PaCO2화Pet-CO2적치，비교PaCO2화Pet-CO2적치급기상관성。결과각시간점적Pet-CO2치균저우PaCO2치，재기복전、기복시화기복방기후3충불동적궤체상태하PaCO2화Pet-CO2정밀절정상관（P<0.05），재16 mmHg중등압력CO2기복상태하，기복후30、60、120 min 3개시간점PaCO2화Pet-CO2적상관성여기복전、기복방기후PaCO2화Pet-CO2적상관성적r치유차별。결론병태비반환자재중등CO2기복압，복강경보조행위방로수술중PaCO2화Pet-CO2시밀절상관적。
Objective To investigate the correlation between arterial partial pressure of CO2 (PaCO2) and end expiratory tidal partial pressure of CO2 (Pet-CO2) in morbidly obese patients during anesthesia for laparoscopic gastric bypass surgery. Methods Forty morbidly obese patients with a body mass index (BMI) between 35 and 50 kg/m2 underwent laparoscopic gastric bypass surgery under general anesthesia. PaCO2 and Pet-CO2 were measured after intubation and before induction of pneumoperitoneum (T0), at 30 min (T1), 60 min (T2), and 120 min (T3) during pneumoperitoneum, and at 30 min (T4) and 60 min (T5) after deflation. Results At each time point of measurement, Pet-CO2 was lower than PaCO2 in all the patients. PaCO2 and Pet-CO2 were positively correlated before, during, and after pneumoperitoneum (P<0.05). At a moderate pressure of CO2 pneumoperitoneum (16 mmHg), the level of correlation between PaCO2 and Pet-CO2 at T1, T2, and T3 differed from that before and after post- pneumoperitoneum. Conclusion PaCO2 and Pet- CO2 are closely correlated during a moderate CO2 pneumoperitoneum in morbidly obese patients undergoing laparoscopic gastric bypass surgery.