二氧化碳气腹对小儿腹腔镜手术期间无创脑氧饱和度的影响

湖南省儿童医院麻醉手术科(湖南省长沙市,410007)

二氧化碳; 腹腔镜; 气腹; 脑氧饱和度; 儿童

Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children.

Hunan Children's Hospital, Chiangsha 410007,china.Corresponding author:Wang Jiangping,Email:hneywjp@163.com

Carbon Dioxide; Laparoscopic; Pneumoperitoneum; Cerebral Oxygen Saturation; Child

DOI: 10.3969/j.issn.1671— 6353.2018.04.017

备注

目的 应用近红外光谱监测局部脑氧饱和度(rSO2),观察腹腔镜手术期间二氧化碳气腹对小儿rSO2的影响。方法 选择行腹腔镜下阑尾切除手术患儿40例。将脑氧监护仪的双侧电极对称贴于患儿额部,采集两侧数据取平均值。记录气腹前、气腹后30 min的rSO2、PaO2、PaCO2、PetCO2、MAP、HR、Hb以及体温。结果 与气腹前比较,PaCO2、PetCO2于气腹后30 min均显著性增加(P<0.05)。气腹前后,rSO2、PaO2、Hb、HR、MAP、体温比较差异无统计学意义。结论 腹腔镜阑尾切除手术CO2气腹期间,虽二氧化碳分压增加,但气腹对脑氧饱和度会有影响。
Objective This study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children. Methods This study comprised forty children who were scheduled for laparoscopic appendectomy. Right and left regional cerebral oxygen saturation, Hemodynamic variables,PaO2、PaCO2、PetCO2、MAP、HR、Hb 、body temperature were recorded. All Parameters were recorded before insufflation and 30min after start of insufflation. Results There were progressive increases in PaCO2 and PetCO2, which were statistically significant after insufflation 30 min(P<0.05).There were not statistically significant in rSO2、HR、PaO2、MAP、Hb 、body temperature after insufflation 30 min. Conclusion Although Carbon dioxide pressure increases during laparoscopic appendectomy, rSO2 was not statistically changed, which may not prove pneumoperitoneum affect cerebral oxygenation under laparoscopic surgery.