不同气腹压力对腹腔镜胃切除术患者中心静脉压的影响及其非监测功能的应用

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Abstract Objective To investigate the effect of carbon dioxide(CO2)artificial pneumoperitoneum with different pneumoperitoneum pressure on central venous pressure in patients undergoing laparoscopic partial gastrectomy.Methods A total of 40 patients with gastric tumors undergoing selective laparoscopic partial gastrectomy under general anesthesia in Huaiyin Hospital of Huai′an City,Jiangsu Province from May 2019 to December 2020 were selected as the study subjects.According to the random number table method,they were divided into group A and group B,with 20 patients in each group.The pneumoperitoneum pressure was set at 10 mmHg in group A and 15 mmHg in group B.The mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO2),central venous pressure(CVP),mean airway pressure(Pmean),end-tidal pressure of carbon dioxide(PETCO2)and arterial partial pressure of carbon dioxide(PaCO2)before pneumoperitoneum(T0),30 min after pneumoperitoneum(T1),60 min after pneumoperitoneum(T2)and 10 min after pneumoperitoneum termination(T3)were compared between the two groups.Results There were no statistically significant differences in MAP,HR and SpO2 between the two groups at different time points(P>0.05).CVP,Pmean,PaCO2 and PETCO2 at T1 and T2 were higher than those at T0,and the differences were statistically significant(P<0.05).CVP,Pmean,PaCO2 and PETCO2 in group B at T1 and T2 were higher than those in group A,and the differences were statistically significant(P<0.05).Conclusion The effect of different pneumoperitoneal pressures on CVP differ,CVP increasing with high pressures.Surgery that requires a controlled low CVP,with an appropriate lower pneumoperitoneum pressure,is beneficial in lowering the CVP,at which point the CVP is no longer used as a monitor of circulatory function but rather as an adjunct to assist in lowering the CVP.

Key words： Pneumoperitoneum pressure Central venous pressure Laparoscopic gastrectomy

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	YE Wei
	CHEN Jin-hong
	YAO Sheng-lai

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YE Wei,CHEN Jin-hong,YAO Sheng-lai. Effect of different pneumoperitoneum pressures on central venous pressure in patients undergoing laparoscopic gastrectomy and application of non-monitoring function[J]. 中国当代医药, 2021, 28(25): 124-127.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I25/124

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