腹腔镜胆囊切除术病人应用小潮气量高频率手控呼吸诱导预防术后恶心呕吐

目的观察腹腔镜胆囊切除术（LC）患者应用小潮气量高频率手控呼吸诱导预防术后呕吐的效果。方法选取ASAⅠ-ⅡLC病人120例，排除心、肺、脑、肾和精神疾病，随机分为三组。A组40例，麻醉诱导静脉滴注阿扎司琼，采用常规潮气量、常规呼吸频率；B组40例，静脉滴注阿扎司琼＋小潮气量高频率手控呼吸诱导；C组40例，未用止吐药，常规潮气量和呼吸频率。比较各组的麻醉持续时间、手术持续时间和不同时间点MAP、HR、SPO2％、PETCO2的情况，术后24小时恶心呕吐的发生率。结果各组的气腹前、气腹后5min、10min、20min、30min的MAP、HR、SPO2％比较差异无统计学意义（P〉0．05），PETC02比较差异具有统计学意义（P〈0．05），各组的麻醉持续时间、手术持续时间比较结果无统计学意义（P〉0．05），A组术后恶心呕吐发生率为20．0％，B组术后恶心呕吐发生率为7．5％，C组术后恶心呕吐发生率为70．0％，结果有统计学意义（P〈0．05）。结论小潮气量高频率手控呼吸诱导可减少气体进入胃内，降低胃内压力，防止CO2滞留，预防术后恶心呕吐，保障了LC的顺利进行。

Laparoscopic Cholecystectomy Patients Used Small Tidal Volume High Frequency Hand Control Breathing Induced the Prevention of Postoperative Nausea and Vomiting

Objective Observation laparoscopic cholecystectomy （LC） patients with high frequency low tidal volume manual effect the prevention of postoperative vomiting induced breathing. Methods Select ASAⅠ - Ⅱ LC patients 120 cases, excluding the heart, lung, brain, kidney and mental illness, were randomly divided into three groups. A group of 40 patients, Anesthesia was induced intravenously Azasetron, Conventional tidal volume, breathing frequency routine; B group of 40 patients, Intravenous infusion azasetron ＋ low tidal volume breathing high fi＇equeney induction manual ; C group of 40 patients, Unused antiemetic, Conventional tidal volume and respiratory rate. Comparing each group duration of anesthesia, surgery duration and at different time points MAP, HR, SPO2% , the situation PET CO2 of 24 hours after the incidence of nausea and vomiting. Results Each group before pneumoperitoneum, 5 min, 10 min, 20 min, 30 min of MAP, HR, SPO2 % difference was not statistically significant （ P 〉 0. 05 ） after pneumoperitoneum, PET CO2 difference was statistically significant （ P 〈 0. 05 ） , duration of anesthesia for each group, duration of surgery showed no statistically significant comparison （ P 〉 0. 05 ） , A group of postoperative nausea and vomiting was 20. 0% in group B of postoperative nausea and vomiting was 7.5% in group C of postoperative nausea and vomiting was 70. 0%, the results were statistically significant （ P 〈 0. 05 ）. Conclusions High frequency low tidal volume breathing induction manual can reduce gas into the stomach, lower stomach pressure and prevent CO2 retention, prevention of postoperative nausea and vomiting, guarantee the smooth progress of the LC.