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目的:观察侧卧位腹膜后气腹对动脉血-呼气末二氧化碳分压差(Pa-ET CO2)的影响,为麻醉过程中调节呼吸机参数提供参考。方法选择侧卧位下行腹膜后腹腔镜手术患者28例, ASA 分级Ⅰ~Ⅱ级。术中持续监测呼气末二氧化碳分压,在气腹前平卧位时、气腹前侧卧位时、气腹后30 min、60 min 和90 min 时行动脉血气分析,计算 Pa-ET CO2。结果气腹前平卧位的 Pa-ET CO2低于气腹前侧卧位[(3.1±2.8)mmHg 比(7.3±2.6)mmHg,P <0.05]。气腹后30 min、60 min 和90 min 的 Pa-ET CO2无显著差异[(9.1±3.1)mmHg、(9.2±3.9)mmHg、(8.9±4.1)mmHg,P >0.05],但均高于气腹前平卧位和侧卧位(P <0.05)。结论侧卧位下腹膜后气腹因体位和气腹的影响而增加 Pa-ET CO2,术中需防止酸中毒,降低 PET CO2值。“,”Objective To observe effects of retroperitoneal insufflation on arterial-end carbon di-oxide partial pressure(Pa-ET CO2 )at lateral position and offer references to parameter regulation of respira-tor in anesthesia.MethodsA total of 28 patients(ASA I ~II grade)with retroperitoneoscopy were enrolled. End-tidal carbon dioxide partial pressure(PET CO2 )was continuously monitored during operation.Blood-gas analysis was performed at the time points of supine position before insufflation,lateral position before in-sufflation,30 min,60 min,and 90 min after insufflation and the PET CO2 was calculated.Results The Pa-ET CO2 at supine position before insufflation was significantly lower than that at lateral position[(3.1 ± 2.8)mmHg vs(7.3 ±2.6)mmHg,P 0.05],but they were all higher than those at supine position and lateral position before insufflation(P <0.05).Conclusion During the retroperitoneal insufflation at lateral position,Pa-ET CO2 is increased by position and insufflation.To prevent the incidence of acidosis,PET CO2 should be decreased during retroperitoneal insufflation at the lateral position.