摘要
目的研究妇科腹腔镜手术中不同麻醉方法对呼吸功能的影响。方法 60例妇科行腹腔镜手术患者,ASA分级Ⅰ~Ⅱ级。按照随机数字表法分将其分为A组和B组,各30例。A组采取腰-硬膜外联合麻醉,B组采取气管插管全身麻醉。比较两组患者麻醉后5 min、气腹后5 min、气腹后15 min、气腹后30 min各时点的呼吸及血气指标。结果两组患者各时间点组内及组间同期血氧饱和度(SpO_2)、碳酸氢根离子(HCO_3^-)、动脉血pH值比较,差异均无统计学意义(P>0.05)。A组患者气腹后5、15 min的呼气末二氧化碳分压(P_(ET)CO_2)分别为(40.57±4.88)、(41.95±4.68)mm Hg(1 mm Hg=0.133 kPa),高于麻醉后5 min的(36.69±5.43)mm Hg;B组患者气腹后5、15 min的P_(ET)CO_2分别为(40.38±4.96)、(41.83±4.57)mm Hg,高于麻醉后5 min的(36.74±5.26)mm Hg;A组患者气腹后5、15 min的二氧化碳分压(PaCO_2)分别为(45.53±5.26)、(46.86±5.12)mm Hg,高于麻醉后5 min的(40.84±5.72)mm Hg;B组患者气腹后5、15 min的PaCO_2分别为(45.49±5.17)、(46.93±5.24)mm Hg,高于麻醉后5 min的(40.91±5.06)mm Hg,差异均具有统计学意义(P<0.05);两组患者各时间点组间同期P_(ET)CO_2、PaCO_2比较,差异均无统计学意义(P>0.05)。A组患者气腹后5、15、30 min的氧分压(PaO_2)分别为(275.75±14.67)、(279.08±14.83)、(281.56±14.23)mm Hg,均低于B组的(331.74±15.86)、(369.51±15.90)、(400.79±15.97)mm Hg,差异具有统计学意义(P<0.05)。A组患者组内各时间点PaO_2比较,差异无统计学意义(P>0.05)。结论对于行妇科腹腔镜手术的患者在建立CO_2气腹后,采取腰-硬膜外联合麻醉对其呼吸功能影响较低,血气指标波动较小。
Objective To investigate the effects on respiratory function in gynecologic laparoscopic surgery. Methods 60 patients ASA physical status Ⅰ-Ⅱ who underwent gynecological laparoscopic surgery were divided into group A and group B according to the random number table method, with 30 cases in each group. Group A adopted lumbar epidural anesthesia, group B adopted endotracheal intubation body anesthesia. The respiratory and blood gas indexes between the two groups of patients at 5 min after anesthesia, 5 min after pneumoperitoneum, 15 min after pneumoperitoneum, and 30 min after pneumoperitoneum were compared. Results There were no statistically significant differences in the SpO2, P（ET）CO2, HCO3^-and arterial blood pH values within the group and between the groups at each time point were compared（P〉0.05）. The P（ET）CO2 index of group A at 5 min, 15 min after pneumoperitoneum were（40.57±4.88）,（41.95±4.68）mm Hg（1 mm Hg=0.133 kPa） respectively, which were significantly higher than（36.69±5.43）mm Hg at 5 min after anesthesia, the P（ET）CO2 index of group B at 5 min, 15 min after pneumoperitoneum were（40.38±4.96）,（41.83±4.57）mm Hg respectively, which were significantly higher than（36.74±5.26）mm Hg at 5 min after anesthesia.The PaCO2 index of group A at 5 min, 15 min after pneumoperitoneum were（45.53±5.26）,（46.86±5.12）mm Hg respectively, which were significantly higher than（40.84±5.72）mm Hg at 5 min after anesthesia, the PaCO2 index of group B at 5 min, 15 min after pneumoperitoneum were（45.49±5.17）,（46.93±5.24）mm Hg respectively, which were significantly higher than（40.91±5.06）mm Hg at 5 min after anesthesia, the differences were statistically significant（P〈0.05）. There were no statistically significant differences of P（ET）CO2 and PaCO2 in the same period between groups at all time points（P〉0.05）. The PaO2 index of group A at 5, 15, 30 min after pneumoperitoneum were（275.75±14.67）,（279.08±14.83）,（281.56±14.23�
作者
张琦
ZHANG Qi(Department of Anesthesiology,The People＇ s Hospital of Yanggu County,Yanggu 252300,China)
出处
《中国现代药物应用》
2018年第13期4-7,共4页
Chinese Journal of Modern Drug Application
关键词
妇科
腹腔镜手术
不同麻醉方法
呼吸功能
Gynecology
Laparoscopic surgery
Different anesthetic methods
Respiratory function
