国际麻醉学与复苏杂志   2013, Issue (1): 6-6
    
腹腔镜下妇科肿瘤切除术中二氧化碳气腹对患者脑血流的影响
郭智星, 孙莉1()
1.北京协和医学院 中国医学科学院肿瘤医院
Effects of carbon dioxide pneumoperitoneum on the cerebral blood flow during gynecological laparoscopic tumor resection
 全文:
摘要：

【摘要】目的 观察妇科肿瘤患者腹腔镜手术期间二氧化碳气腹对患者脑血流的影响。方法 选择行腹腔镜手术的妇科肿瘤患者40例，ASAI～II级，没有心、脑系统疾病，于气腹前、气腹后头低臀高位20分钟分别采取桡动脉和颈内静脉血，测定PaO2、PaCO2、SaO2、颈内静脉分压（PjvO2）和血氧饱和度（SjvO2）等值。结果 与气腹前比较，气腹后20分钟的SjvO2、颈内静脉血氧含量（CjvO2）和PaCO2均显著性增加（P<0.01），脑动静脉血氧含量差（Ca-jvDO2）显著性减少（P<0.01）。结论 妇科肿瘤患者腹腔镜手术期间，CO2气腹对脑循环产生显著影响，CBF显著增加，Ca-jvDO2明显减少。这种变化提示可能存在脑细胞缺氧。
关键词： 【关键词】妇科腹腔镜；二氧化碳气腹；脑血流
Abstract:

Effects of carbon dioxide pneumoperitoneum on the cerebral blood flow during gynecological laparoscopic tumor resection GUO Zhixing,SUN Li.Department of Anesthesiology,Cancer Institute ＆Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,China Corresponding author: SUN Li,Email:xingbj2000@yahoo.com.cn 【Abstract】 Objective To observe the effects of carbon dioxide pneumoperitoneum on the cerebral blood flow of the patient which undergoing gynecological laparoscopic tumor resection. Methods 40 ASA grade I～II patients with gynecologic tumor undergoing laparoscopic surgery without known cerebral or cardiovascular system disease were selected．PaO2、PaCO2、SaO2、PjvO2、SjvO2 values were recorded before insufflation and 20 min after the insufflation in the Trendelenburg position. Results SjvO2、PjvO2、CjvO2、PaCO2 increased obviously(P<0.01) and Ca-jvDO2 decreased significantly(P<0.01) 20 min after insufflation compared with those before insufflation. Conclusions The CO2 pneumoperitoneum have obvious effect on the change of the cerebral blood circulation during the operation of gynecology laparoscopy，cerebral blood flow increased remarkably and Ca-jvDO2 decreased significantly.This kind of change implied anoxia of brain.
Key words: 【Key words】Gynecology Laparoscopy；CO2 pneumoperitoneum；cerebral blood