婦科腹腔鏡術中不同呼吸參數設置對呼吸力學及呼吸末二氧化碳分壓(P-,ET-CO-,2-)的影響.pdf

1、山西醫(yī)科大學碩士學位論文婦科腹腔鏡術中不同呼吸參數設置對呼吸力學及呼吸末二氧化碳分壓（PCO）的影響姓名：劉鍵申請學位級別：碩士專業(yè)：麻醉學指導教師：馬平20090508山西醫(yī)科大學碩士學位論文EffectsofdifferentmechanicalventilationmethodsonrespiratoryandPETC02inpatientsduringgynecologicallaparoscopicoperationsAbst

2、ractObjective：ToobservetheeffectsofdifferentmechanicaIventilationmethodsonrespiratorymechanicsandPETC02duringgynecologicallaparoseopicoperationsMethods：80casesundergoinggynecologicallaparoscopicoperations，WhoseASAI～IIgra

3、deandagesrangefrom35to50yearsoldandtimefrom15to2hours，weredividedintofourgroupsafterintrachealintubationVentilatorparametersweresetupVT=8ml／kgandf=12／minAfterpneumoperitoneumventilatorparametersweredifferent：VT=8ml／kgf=l

4、S／miningroupIVT=8ml／kgf=12／miningroupIIVT8ml／kgf=18／rainingroupⅢMonitorandrecordPpcak，Pplatlungcompliance(CL)andendtidalC02(PETC02)at5minutesafterintubation(t1)，15minaftertrendelenburgposition(t2)，30minafterIrendelenburg

5、position03)，60minaftertrendelenburgposition(DResults：ThePpeakandPplatincreasesignificantlyafterIrendelenburgpositionandpneumoperitonettm(P005)infourgroupsofpatients，andthegroupⅡismoresignificant(PO05)PpeakandPplatoffourg

6、roupsincreasedhigherandhigherastimepassedButthereisnosignificantdifferencesbetweent3andt4，CLoffourgroupsdecreasedsignificantlyaltertrendelenburgpositionandpneumoperitoneum(PO05)ThegroupsI，IIandIVdecreasedmoresignificantl

7、ythangroupⅢaftertrendelenburgpositionandpneumoperitoneum(P005)PETC02offourgroupsincreasedsignificantlyaftertrendelenburgpositionandpneumoperitoneumInadditionitbecamehigherandhigherastimepassed(PO05)Itincreasedmoresignifi

8、cantlyGroupIVthangroupI，ⅡandⅢaftertrendelenburgpositionandpneumoperitoneum(P005)Buttherearenosigmficantlydifferencesbetweenthet3andhtimepointsCompareamonggroupsI，IIandIII，itincreasedhighergroupsIIandIIIatt3timepointThere

9、alenosignificantdifferencesatthet2，t4timepohItConclusion：Duringgynecologicallaparoscopicoperations，differentmechanicalventilatorparametersCanchangerespiratorymechanicsandPETC02Beforepneumoperitoneumfisremainedat12times／m

10、inandVT8ml／kgAfterpneurnoperitoneumMVisincreasedby10％andfissetto15times／minwhichareamorereasonablebreathingparametersKeywords：gynecologicallaparoscopicoperations，trendelenburgpositionpneumoperitoneum，pneumodynamicsPETC02