概述 由于具备创伤小、术后恢复快等优点，后腹腔镜术在泌尿外科老年患者中的应用日益增多。然而后腹腔镜术本身的特点以及老年患者特殊的生理特点使得该类手术中患者更易发生较高程度的高碳酸血症，严重威胁老年患者围术期的安全及预后。目的 寻找术中对老年患者动脉血二氧化碳分压（arterial carbondioxide partial pressure , PaCO2 , mmHg）进行准确监测和对高碳酸血症进行实时监测和有效通气调控的方法。内容 就近年来关于老年患者后腹腔镜手术中高碳酸血症的产生机制、及其对老年患者生理功能的影响以及监测、处理方法进行综述。趋向 经皮二氧化碳分压监测（transcutaneous partial pressure of carbon dioxide , PcCO2 , mmHg）已被证实可以用于成年人多种手术的血二氧化碳气连续监测并于动脉血二氧化碳分压值有很好的相关性；呼气末正压（positive end-expiratory preassure , PEEP）也被证实在腹腔镜手术中对改善通气功能有一定作用。这些方法或可为老年患者后腹腔镜手术中的监测提供新的选择。
Background Because of the smaller trauma and faster postoperative recovery, retroperitoneoscopic urologic surgery of old people has become more and more popular. However, the special features of retroperitoneoscopic surgery itself and the aged patients’ physiological functionsrefractory make hypercapnia appear more frequently which threaten the old people’s lives. Objective Find a way to accurately monitor the arterial carbon dioxide partial pressure for hypercapnia during operations and carry out effective solutions of respiratory adjustments on time. Content This article reviewed the mechanisms of hypercapnia on old patients undergoing prolonged retroperitoneoscopyic surgery and the methods of monitoring and respiratory adjustment solutions. Trend Transcutaneous carbon dioxide monitoring has been proved feasible to predict the arterial carbon dioxide partial pressure accurately in adults during different operations. PEEP has been proved to improve patients’ ventilatory functions in some degree .Both methods may provide a new option for monitoring during retroperitoneoscopyic surgery.
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