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目的观察腹腔镜手术二氧化碳(CO2)气腹对婴幼儿围手术期呼吸和循环功能的影响,并探讨应对措施。方法选择1个月～3岁的婴幼儿进行分组:A组(婴儿组),B组(幼儿组),C组(开腹手术组)。观察各组气腹前5 min(T0)、气腹后5 min(T1)、气腹后30 min(T2)及停止气腹10 min(T3),各组患儿的心率(HR)、血氧饱和度(SpO2)、血压(SBP/DBP)、血气分析结果[pH、pa(CO2)、pa(O2)]等指标。采用SPSS 13.0软件进行统计学处理。结果 A、B 2组气腹后T1、T2与气腹前T0相比HR、pa(CO2)、SDP、DBP均增高(Pa<0.05),血pH值、SpO2、pa(O2)均无明显变化(Pa>0.05);A、B 2组气腹停止后T3的监测数据与气腹前T0相比无明显变化。A、B 2组气腹后T1、T2与C组比较,pa(CO2)分压增高(P<0.05),其他监测数据差异无统计学意义。结论腹腔镜CO2气腹对婴幼儿围手术期呼吸和循环功能有明显影响,加强麻醉管理,精确手术操作,婴幼儿腹腔镜手术仍是安全的,不会明显增加手术风险。
Objective To observe the effects of pneumoperitoneum (CO2) pneumoperitoneum on the respiration and circulatory function in infants during perioperative period and to discuss the countermeasures. Methods One-month to three-year-old infants were divided into group A (infants), group B (infants) and group C (laparotomy). The levels of heart rate (HR) and blood in each group were observed after 5 min (T0), 5 min after pneumoperitoneum (T1), 30 min after pneumoperitoneum (T2) and 10 min after pneumoperitoneum was stopped Oxygen saturation (SpO2), blood pressure (SBP / DBP), blood gas analysis results [pH, pa (CO2), pa (O2)] and other indicators. Using SPSS 13.0 software for statistical analysis. Results After pneumoperitoneum, the HR, pa (CO2), SDP and DBP of group A and B 2 after pneumoperitoneum were significantly higher than those before pneumoperitoneum (Pa <0.05) (Pa> 0.05). The monitoring data of T3 after pneumoperitoneum stop in group A and group B did not change significantly compared with T0 before pneumoperitoneum. Compared with C group, the partial pressure of pa (CO2) increased in group A and group B after pneumoperitoneum (P <0.05), while there was no significant difference in other monitoring data. Conclusions Laparoscopic CO2 pneumoperitoneum has a significant effect on the respiration and circulatory function in infants during perioperative period. It is safe to strengthen anesthesia management and precise operation, and infantile laparoscopy is safe and does not significantly increase the operation risk.