本文選題：麻醉 + 高碳酸血癥��； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的探討允許性高碳酸血癥對腹腔鏡全子宮切除手術(shù)的應(yīng)用價值及對患者IL-6、IL-10及TNF-a的影響。方法將46例擇期行腹腔鏡全子宮切除術(shù)患者隨機(jī)分為對照組(C組,23例)和允許性高碳酸血癥組(P組,23例)。兩組全麻誘導(dǎo)后,通過動脈血?dú)饨Y(jié)果調(diào)整機(jī)械通氣參數(shù),P組PaCO2維持在45～60mmHg,pH值維持在7.25-7.35之間；對照組維持PaCO2維持在35～45mmHg,pH值維持在7.35-7.45之間。記錄To(麻醉前)、T1(麻醉誘導(dǎo)后)、T2(氣腹0.5小時)、T3(氣腹1小時)、T4(氣腹2小時)、T5(結(jié)束氣腹0.5小時)、T6(結(jié)束氣腹1小時)時間點(diǎn)血壓、心率、血?dú)夥治?并測定IL-6、IL-10及TNF-α濃度。結(jié)果兩組病人年齡、體重、氣腹時間、手術(shù)時間及拔管時間比較無統(tǒng)計學(xué)意義(P0.05)；C組在T5、T6時點(diǎn)的平均動脈壓明顯比P組高,差異有統(tǒng)計學(xué)意義(P0.05),P組T2時點(diǎn)的心率較P組高,差異有統(tǒng)計學(xué)意義(P0.05)；P組T2～T6時IL-6和TNF-α均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05或P0.01),兩組IL-10差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論允許性高碳酸血癥下行腹腔鏡全子宮切除術(shù),IL-6、 TNF-α均低于正常通氣組,提示這種通氣方式可能適合此類手術(shù)的麻醉維持。
[Abstract]:Objective to investigate the value of permissive hypercapnia in laparoscopic hysterectomy and its effect on IL-6 IL-10 and TNF-a. Methods 46 patients undergoing laparoscopic hysterectomy were randomly divided into control group (n = 23) and permitted hypercapnia group (n = 23). After induction of general anesthesia, the parameters of mechanical ventilation were adjusted by arterial blood gas. The pH value of PaCO2 in group P was maintained between 7.25 and 7.35 in group P and the pH value of PaCO2 in control group was between 7.35 and 7.45 mm. The blood pressure, heart rate and blood gas were recorded at the time point of ToT _ 1 (after induction of anesthesia), and the concentrations of IL-10 and TNF- 偽 were measured. Results there was no significant difference in age, body weight, pneumoperitoneum time, operation time and extubation time between the two groups. The mean arterial pressure at T5 / T6 in group C was significantly higher than that in group P, and the heart rate in group P was significantly higher than that in group P at T2. The difference of IL-6 and TNF- 偽 in T2~T6 group was significantly lower than that in control group (P 0.05 or P 0.01). There was no significant difference in IL-10 between the two groups (P 0.05). Conclusion the levels of IL-6 and TNF- 偽 in laparoscopic total hysterectomy under permissive hypercapnia are lower than those in normal ventilation group, suggesting that this ventilation may be suitable for anesthesia maintenance.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 肖超烈;朱碧嬡;;允許性高碳酸血癥治療COPD急性發(fā)作期合并Ⅱ型呼吸衰竭[J];廣東醫(yī)學(xué);2011年05期

2 毛倩倩;鄒俊;張中軍;;七氟烷后處理對40例患者體外循環(huán)下肺靜脈炎癥因子的影響[J];重慶醫(yī)學(xué);2012年19期

3 陳真;邱燦金;;七氟烷對腹腔鏡膽囊切除術(shù)患者圍術(shù)期炎癥因子的影響[J];實(shí)用醫(yī)學(xué)雜志;2014年04期

4 席子明;;外科及移植和麻醉應(yīng)激對機(jī)體細(xì)胞因子活性的影響[J];中國組織工程研究與臨床康復(fù);2011年18期

5 廖景文;;允許性高碳酸血癥通氣法中動脈血二氧化碳分壓適宜范圍探討[J];中國實(shí)用兒科雜志;2012年02期

，

本文編號：1858703