论文部分内容阅读
目的观察腹腔镜直肠癌切除术中CO2气腹对脑氧供需平衡及脑血流的影响。方法所有患者在麻醉前、CO2气腹前、CO2气腹后10、30min和关气腹后10、30min,分别采集颈内静脉球部和桡动脉血,进行动、静脉血气分析,及血氧饱和度(SaO2)监测,并根据Fick公式计算动脉血氧值(CaO2)、颈内静脉球部血氧含量(CjvO2)和脑动、静脉血氧含量(CajvDO2)。结果气腹前与麻醉前比较SaO2、CaO2、PjvO2、CajvDO2等指标变化不显著,而气腹后10与30min的各项指标明显有差异,特别是脑动、静脉血氧值较前明显降低。结论在腹腔镜直肠癌手术过程中采集颈内静脉球部和桡动脉血,进行动、静脉血气分析,及血氧饱和度(SaO2)监测,可以有效反应出脑氧供需平衡及脑血流情况,可以使术者及时了解患者情况,并做出相应的治疗。
Objective To observe the effects of CO2 pneumoperitoneum on cerebral oxygen supply and demand balance and cerebral blood flow during laparoscopic resection of rectal cancer. Methods Before and after CO2 pneumoperitoneum, 10, 30 min after CO2 pneumoperitoneum and 10, 30 min after pneumoperitoneum, all the patients were collected the internal jugular bulb and radial artery, and the arterial and venous blood gas analysis and the blood oxygen (SaO2), and calculated the CaO2, CjvO2 and CajvDO2 according to the Fick formula. Results Before pneumoperitoneum compared with before anesthesia SaO2, CaO2, PjvO2, CajvDO2 and other indicators did not change significantly, and 10 and 30min after pneumoperitoneum were significantly different indicators, especially cerebral artery and venous blood oxygen values were significantly lower than before. Conclusions During the operation of laparoscopic rectal cancer, collecting the internal jugular bulb and radial artery, analyzing arterial and venous blood gas and monitoring the blood oxygen saturation (SaO2) can effectively reflect the balance of cerebral oxygen supply and demand and cerebral blood flow , You can make the surgeon to keep abreast of the patient’s condition, and make the appropriate treatment.