CAJ | 학술논문

目的：分析加温二氧化碳气腹对妇科腹腔镜手术患者血气的影响及手术麻醉干预措施。方法选取2012年5月到2014年5月于深圳市妇幼保健院妇科接受腹腔镜手术治疗的120例患者作为研究对象，随机分为加温二氧化碳气腹机组和不加温二氧化碳气腹机组，两组均为60例，对比观察两组患者手术前后血气变化情况。结果术前，两组患者 pH 值、PCO2、PO2、BE、HCO3值对比差异无统计学意义。术后，加温二氧化碳气腹机组患者 P02值为（215.60±15.20）mmHg，明显低于术后不加温二氧化碳气腹机组患者的（312.92±23.78）mmHg；术后加温二氧化碳气腹机组患者 PCO2值为（15.11±0.22）mmHg，低于术后不加温二氧化碳气腹机组；术后加温二氧化碳气腹机组患者 BE 值为（-10.22±1.94）mmol／L，明显低于术后不加温二氧化碳气腹机组 BE 值；P02、PCO2、BE 值与不加温二氧化碳气腹机组患者术后对比，差异有统计学意义。结论建立二氧化碳气腹时的加温处理是影响患者手术安全性及术后并发症发生率的关键因素，重视术前气腹建立的加温处理，维持患者的体温，以降低术后寒战发生率，提高手术治疗效果。当出现二氧化碳潴留时，及时行血气分析，进行良好的麻醉干预，是保证患者安全的关键因素。
목적：분석가온이양화탄기복대부과복강경수술환자혈기적영향급수술마취간예조시。방법선취2012년5월도2014년5월우심수시부유보건원부과접수복강경수술치료적120례환자작위연구대상，수궤분위가온이양화탄기복궤조화불가온이양화탄기복궤조，량조균위60례，대비관찰량조환자수술전후혈기변화정황。결과술전，량조환자 pH 치、PCO2、PO2、BE、HCO3치대비차이무통계학의의。술후，가온이양화탄기복궤조환자 P02치위（215.60±15.20）mmHg，명현저우술후불가온이양화탄기복궤조환자적（312.92±23.78）mmHg；술후가온이양화탄기복궤조환자 PCO2치위（15.11±0.22）mmHg，저우술후불가온이양화탄기복궤조；술후가온이양화탄기복궤조환자 BE 치위（-10.22±1.94）mmol／L，명현저우술후불가온이양화탄기복궤조 BE 치；P02、PCO2、BE 치여불가온이양화탄기복궤조환자술후대비，차이유통계학의의。결론건립이양화탄기복시적가온처리시영향환자수술안전성급술후병발증발생솔적관건인소，중시술전기복건립적가온처리，유지환자적체온，이강저술후한전발생솔，제고수술치료효과。당출현이양화탄저류시，급시행혈기분석，진행량호적마취간예，시보증환자안전적관건인소。
Objective To analyze the effect of the heating carbon dioxide pneumoperitoneum on blood gas of patients with gynecological laparoscopic surgery and to explore measures of anesthetic intervention. Methods A total of 1 20 cases of gynecological patients who received laparoscopicoperation therapy in our hospital from May 201 2 to May 201 4 were included and were randomly divided into group A and group B with 60 cases in each group.The patients in group A were treated with the heated carbon dioxide while patients in group B were treated with pneumoperitoneum of non-heated carbon dioxide,Changes of blood gas of the patients in the two groups were compared before and after operation. Results The differences in pH,PCO2 ,PO2 and HCO3 were significant before the surgery.After the surgery,the PO2 value in group A was (21 5.60 ±1 5.20)mmHg,which was significantly lower than (31 2.92 ±23.78)mmHg in group B.The PCO2 value in group A was (1 5.1 1 ±0.22)mmHg,which lower than that in group B.The BE value in group A was (-1 0.22 ± 1 .94)mmol/L after the surgery,which was lower than that in group B. Conclusion Heating treatment is the key factor to affect the operation safety of the patients and the incidence of postoperative complications when carbon dioxide pneumoperitoneum is established.Therefore the heating treatment must be closely monitored before the operation in order to maintain body temperature and to reduce the incidence of postoperative shivering after the operation.When carbon dioxide retention occurs,timely blood gas analysis and anesthetic intervention are crucial to the safety of the patients.