小儿腹腔镜术中二氧化碳气腹压的影响和护理措施

发表时间：2014-01-15 浏览次数：912次

引用：

林惠玲.小儿腹腔镜术中二氧化碳气腹压的影响和护理措施[J].吉林医学,2013,34(22):4540-4541.

关键词：

小儿腹腔镜;二氧化碳气腹;护理

作者：

林惠玲

作者单位：

广东省深圳市龙岗区第二人民医院手术室，广东深圳518112

出版年份：

2013

期刊页数：

4540-4541.

收录者：

知网

摘要：

目的：观察小儿腹腔镜手术中二氧化碳气腹压力对呼吸循环系统的影响，并采取相应的护理安全管理措施，做好护理配合工作，增加手术安全性。方法：60例小儿腹腔镜手术患者分为低(A)、中(B)、高(C)气腹压三组，气腹压分别为4 mm Hg(1 mm Hg=01333 kPa)，6 mm Hg，8 mm Hg，观察各组气腹前5分钟(T0) ;气腹后5分钟(T1);气腹后30分钟(T2)及停止气腹10分钟(T3)各组患儿的呼气末二氧化碳分压(PET CO2))和平均动脉压(MAP)等指标的变化。结果：二氧化碳充气过程中，腹内压的改变对呼吸循环系统有明显影响，其程度随CO2充气时腹内压增高增强。结论：适当减缓CO2充气速度，控制流量，有助于减轻气腹对呼吸循环的影响。只要加强监测，处置妥当，CO2气腹不会明显增加手术风险。 Objective：To observe the effect of carbon dioxide pneumoperitoneum on nespivatory and circulatory system in pediatric surgery and to take the appropriate nursing safery management measures,do the nursing cooperation work,increase the operation securityMethod：60 patients with pediatric laparoscopic surgery were divided into three groups,low(A)group,medium(B)group,high(C)group,and their pneumoperitoneum pressure were 4 mmHg,6 mmHg,8 mmHg respectively,we observed the charge of index such as partial pressure of carbon dioxide in endex piratiry(PE1 CO2)and mean arterial pressure(MAP)in each group 5 minutes before pneumoper itoneum(TO),5 min after pneumoperitoneum(T1),30 min after preumoperitoneum(T2),10 min(T3) after stopping the pneumoperitoneumResults：In the process of inflating the carbon dioxide the change of intra-abodominal pressure had significant effect on the change of respiratory system,and the degree enhanced with increaed intra-abdominal pressure when inflating CO2Conclusion：Mitigating the CO2 velocith appropriately,comtrolling the flow.can help recuce the impact of pneumoperitoneum on respiratory.If we can strengthen monitoring and dispose in order CO2 pneumopetitoneum does not increase the risk of surgery.

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