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目的探究不同通气模式对泌尿外科腹腔镜手术患者动脉血气及气道压的影响。方法 100例进行泌尿外科腹腔镜手术的患者随机分为观察组和对照组,各50例。其中观察组增加机械通气频率3次/min(每分钟通气量增加16.0%左右),对照组增加机械通气频率2次/min(每分钟通气量增加24.0%左右)。对比两组患者CO2气腹前后的动脉血气、呼气末二氧化碳(PETCO2)、气道压力(Paw)。结果气腹前,两组患者的p H、Pa CO2(二氧化碳分压)、PETCO2、Paw等指标对比差异无统计学意义(P>0.05);气腹后,两组患者的p H较术前有所升高,Pa CO2、PETCO2、Paw有所降低,差异有统计学意义(P<0.05);气腹后,观察组患者的p H高于对照组,Pa CO2和Paw低于对照组,差异有统计学意义(P<0.05),两组PETCO2差异无统计学意义(P>0.05)。结论在泌尿外科腹腔镜手术中,对患者呼吸功能的监测极为重要,应用每分钟通气量提高24.0%进行调节,可有效改善CO2气腹导致的Pa CO2增加状况。
Objective To investigate the effects of different ventilation modes on arterial blood gas and airway pressure in patients undergoing urology laparoscopic surgery. Methods 100 cases of urology laparoscopic surgery patients were randomly divided into observation group and control group, 50 cases each. The observation group increased the frequency of mechanical ventilation 3 times / min (ventilation increased 16.0% per minute), while the control group increased mechanical ventilation frequency 2 times / min (ventilation increased 24.0% per minute). The arterial blood gas, end-tidal carbon dioxide (PETCO2) and airway pressure (Paw) before and after CO2 pneumoperitoneum were compared between the two groups. Results Before pneumoperitoneum, there was no significant difference in p H, Pa CO2 (partial pressure of carbon dioxide), PETCO2, Paw and other indexes between the two groups (P> 0.05). After pneumoperitoneum, (P <0.05). After pneumoperitoneum, the p H in observation group was higher than that in control group, and PaCO 2 and PaW in control group were lower than those in control group The differences were statistically significant (P <0.05). There was no significant difference in PETCO2 between the two groups (P> 0.05). Conclusions In urology laparoscopic surgery, it is very important to monitor the respiratory function of patients. The adjustment of 24.0% ventilation per minute can effectively improve the increase of Pa CO2 caused by CO2 pneumoperitoneum.