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婴儿腹腔镜手术气腹压力对腹腔容积的影响

胡博   

  1. 天津儿童医院
  • 收稿日期:2011-09-22 修回日期:2012-03-31 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 胡博

Influence of abdominal space in different CO2 pneumoperitoneum pressure in neonates and younger infants undergoing laparoscopy

  • Received:2011-09-22 Revised:2012-03-31 Published:2012-08-15 Online:2012-08-15

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摘要： 目的 探讨新生儿及小婴儿腹腔镜手术气腹压力对腹腔容积的影响。 方法 20例 腹腔镜手术患儿，在气腹前，气腹压力5mmHg和10mmHg，分别记录患儿腹围3，心率(HR)、平均动脉压(MAP)，血氧饱和度(SiO2)，呼气末二氧化碳分压(PETCO2)。对比不同气腹压力下各参数的变化趋势。结果 随气腹压力增长，腹围3，HR，MAP，PETCO2逐渐升高，且P<0.05。5mmHg气腹压力可使腹腔容积增加约35%，10mmHg气腹压仅可使腹腔容积再增加约11%。结论 较低气腹压力已经可以提供较充足的手术空间，故应更多顾及CO2气腹对呼吸循环的影响，以较低气腹压完成手术。

关键词: 腹腔镜手术, 气腹, 压力, 新生儿, 婴幼儿

Abstract: 【Abstract】 Objective To observe the change and correlation of abdominal space in different CO2 pneumoperitoneum pressure. Methods Twenty cases undergoing laparoscopic surgery were monitored cubic abdominal circumference, HR, MAP, SiO2, PETCO2 before pneumoperitoneum, pneumoperitoneum pressure 5mmHg and 10mmHg. Result Cubic abdominal circumference, HR, MAP, PETCO2 significantly increased with pneumoperitoneum pressure increasing, P<0.05. Abdominal cavity volume would be increased 35% by pneumoperitoneum pressure 5mmHg, while get another 11% abdominal cavity volume by 10mmHg. Conclusion Since lower pneumoperitoneum pressure could meet requirement of laparoscopic operation, we should pay more attention to the interference of CO2 pneumoperitoneum on physiological function.

Key words: laparoscopic surgery, pneumoperitoneum, pressure, neonates, younger infants