南昌大学学报(医学版)
南昌大學學報(醫學版)
남창대학학보(의학판)
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
10期
48-50
,共3页
气腹%动脉血二氧化碳分压%呼气末二氧化碳分压%腹腔镜胃癌根治术
氣腹%動脈血二氧化碳分壓%呼氣末二氧化碳分壓%腹腔鏡胃癌根治術
기복%동맥혈이양화탄분압%호기말이양화탄분압%복강경위암근치술
pneumoperitoneum%PaCO2%PETCO2%laparoscopic-assisted radical gastrectomy for gastric cancer
目的:探讨腹腔镜胃癌根治术二氧化碳(CO2)气腹对动脉血二氧化碳分压(PaCO2)及呼气末二氧化碳分压(PETCO2)的影响。方法择期全身麻醉下行腹腔镜胃癌根治术患者60例,分别在气腹开始前5 min(T0)、建立气腹后15 min(T1)、30 min(T2)、45 min(T3)及停气腹后5 min(T4)时采集动脉血测定 PaCO2及 PETCO2,计算PaCO2与 PETCO2的差值(Pa-ETCO2)和 Pa-ETCO2与 PaCO2的比值(Pa-ETCO2/PaCO2)。结果60例患者手术时间为175~285(227.8±42.6)min,气腹时间为121~158(136.3±11.8)min。T0时 PaCO2、PETCO2、Pa-ET-CO2和 Pa-ETCO2/PaCO2变化与 T1比较差异均无统计学意义(均 P >0.05)。T2、T3时患者 PaCO2、PETCO2、Pa-ETCO2和 Pa-ETCO2/PaCO2明显高于 T0和 T1(均 P <0.05)。T4时患者的 PaCO2和 PETCO2较 T2、T3明显降低,Pa-ETCO2和 Pa-ETCO2/PaCO2较 T2、T3明显升高(均 P <0.05)。结论腹腔镜胃癌根治术中 PETCO2不能准确反映 PaCO2,且两者差异随 CO2气腹时间的延长而扩大。
目的:探討腹腔鏡胃癌根治術二氧化碳(CO2)氣腹對動脈血二氧化碳分壓(PaCO2)及呼氣末二氧化碳分壓(PETCO2)的影響。方法擇期全身痳醉下行腹腔鏡胃癌根治術患者60例,分彆在氣腹開始前5 min(T0)、建立氣腹後15 min(T1)、30 min(T2)、45 min(T3)及停氣腹後5 min(T4)時採集動脈血測定 PaCO2及 PETCO2,計算PaCO2與 PETCO2的差值(Pa-ETCO2)和 Pa-ETCO2與 PaCO2的比值(Pa-ETCO2/PaCO2)。結果60例患者手術時間為175~285(227.8±42.6)min,氣腹時間為121~158(136.3±11.8)min。T0時 PaCO2、PETCO2、Pa-ET-CO2和 Pa-ETCO2/PaCO2變化與 T1比較差異均無統計學意義(均 P >0.05)。T2、T3時患者 PaCO2、PETCO2、Pa-ETCO2和 Pa-ETCO2/PaCO2明顯高于 T0和 T1(均 P <0.05)。T4時患者的 PaCO2和 PETCO2較 T2、T3明顯降低,Pa-ETCO2和 Pa-ETCO2/PaCO2較 T2、T3明顯升高(均 P <0.05)。結論腹腔鏡胃癌根治術中 PETCO2不能準確反映 PaCO2,且兩者差異隨 CO2氣腹時間的延長而擴大。
목적:탐토복강경위암근치술이양화탄(CO2)기복대동맥혈이양화탄분압(PaCO2)급호기말이양화탄분압(PETCO2)적영향。방법택기전신마취하행복강경위암근치술환자60례,분별재기복개시전5 min(T0)、건립기복후15 min(T1)、30 min(T2)、45 min(T3)급정기복후5 min(T4)시채집동맥혈측정 PaCO2급 PETCO2,계산PaCO2여 PETCO2적차치(Pa-ETCO2)화 Pa-ETCO2여 PaCO2적비치(Pa-ETCO2/PaCO2)。결과60례환자수술시간위175~285(227.8±42.6)min,기복시간위121~158(136.3±11.8)min。T0시 PaCO2、PETCO2、Pa-ET-CO2화 Pa-ETCO2/PaCO2변화여 T1비교차이균무통계학의의(균 P >0.05)。T2、T3시환자 PaCO2、PETCO2、Pa-ETCO2화 Pa-ETCO2/PaCO2명현고우 T0화 T1(균 P <0.05)。T4시환자적 PaCO2화 PETCO2교 T2、T3명현강저,Pa-ETCO2화 Pa-ETCO2/PaCO2교 T2、T3명현승고(균 P <0.05)。결론복강경위암근치술중 PETCO2불능준학반영 PaCO2,차량자차이수 CO2기복시간적연장이확대。
Objective To investigate the effects of carbon dioxide pneumoperitoneum on arteri-al partial pressure of carbon dioxide(PaCO2 )and partial pressure of end-tidal carbon dioxide (PETCO2 )during laparoscopic-assisted radical gastrectomy for gastric cancer.Methods Arterial blood samples were obtained 5 minutes before the creation of pneumoperitoneum(T0 ),15(T1 ),30 (T2 )and 45 minutes(T3 )after the creation of pneumoperitoneum,and 5 minutes after the end of pneumoperitoneum(T4 )for the determination of PaCO2 and PETCO2 in 60 patients undergoing e-lective laparoscopic-assisted radical gastrectomy for gastric cancer.The PaCO2-PETCO2 (Pa-ET-CO2 )difference and Pa-ETCO2/PaCO2 ratio were calculated.Results The operation time was 175-285(227.8 ± 42.6)minutes.The pneumoperitoneum time was 121-158(136.3 ± 11.8)mi-nutes.There were no differences in PaCO2 ,PETCO2 ,Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio between T0 and T1 (P > 0.05).Compared with T0 and T1 ,PaCO2 ,PETCO2 ,Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio increased at T2 and T3 (P <0.05).Compared with T2 and T3 ,PaCO2 and PETCO2 decreased but Pa-ETCO2 difference and Pa-ETCO2/PaCO2 ratio increased at T4 (P <0.05).Conclusion PETCO2 can not accurately reflect the PaCO2 during laparoscopic-assisted radical gastrectomy for gastric cancer,and Pa-ETCO2 difference increases with the exten-sion of pneumoperitoneum time.