异丙酚用于腰硬联合麻醉对患者围术期氧代谢的影响

目的:探讨异丙酚复合腰硬联合麻醉对腹腔镜手术患者氧代谢的影响。方法:选取2012年5月-2013年7月在我院进行妇科腹腔镜手术的患者153例,均采用异丙酚复合腰硬联合麻醉。观察并记录患者在麻醉前、麻醉后、气腹15 min、30 min、60 min及放气腹15 min的氧代谢。结果;与麻醉前比较,麻醉后及气腹过程中的氧供(DO2)较麻醉前下降,但无统计学意义(P0.05);而氧耗(VO2)、摄氧率(ERO2)均明显下降,差异具有统计学意义(P0.05);pH值、HCO3-1]、动脉二氧化碳分压(PaCO2)、混合静脉二氧化碳分压(PvCO2)、动脉氧分压(PaO2)、混合静脉氧分压(PvO2)、动脉血氧浓度(SaO2)及混合静脉血氧浓度(SvO2)与均呈显著性差异,具有统计学意义(P0.05);放气腹后15 min各项参数与麻醉前比较,差异无统计学意义(P0.05)。结论:异丙酚复合腰硬联合麻醉效果良好,但对患者的氧代谢有一定影响,手术中应注意检测患者的呼吸循环功能。

Effect of Propofol Compound Anesthesia on the Oxygen Metabolism of Patients in the Operation

Objective:To explore the effect of propofol compound anesthesia on the oxygen metabolism of patients with laparoscopic surgery.Methods:153 cases who were undergoing the gynecologic laparoscopic surgery and taken the propofol compound anesthesia in our hospital fromMay 2012 to July 2013 were selected. The oxygen metabolismof patients before the anesthesia, after the anesthesia, pneumoperitoneum for 15 min, 30 min, 60 min and after the pneumoperitoneum for 15 min were observed and recorded.Results:After anesthesia and oxygen supply in the process of pneumoperitoneum, DO2 was lower than before, but there was no statistically significant difference (P>0.05); The VO2, ERO2 were significantly lower with statistically significant difference (P<0.05); There were statistically significant differences about the PHvalue, HCO3 -1, PaCO2, PvCO2, PaO2, PvO2, SaO2 and SvO2 before and after the anesthesia(P<0.05); There was no statistically significant difference before the anesthesia and after the pneumoperitoneum for 15 min (P>0.05).Conclusion:Propofol compound anesthesia has better effects for laparoscopic surgery. It is suggested that we should pay attention to detecting the oxygen metabolismof patients so as to maintain the respiratory function.