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腹腔镜CO_2气腹对动脉血气、血流动力学和白介素-6的影响及尼卡地平的干预作用

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摘要 目的探讨CO2气腹对腹腔镜胆囊切除术患者动脉血气、血流动力学和血浆白介素-6(IL-6)的影响及尼卡地平的干预作用。方法选择腹腔镜胆囊切除术治疗的患者60例。随机分为尼卡地平组和对照组,每组均为30例。手术开始建立CO2气腹时,尼卡地平组静脉注射尼卡地平10μg.kg-1,然后用微量输注泵持续泵入尼卡地平5μg/(kg.min)。对照组则不用尼卡地平而完成麻醉和手术。两组患者分别于气腹前(T0)和气腹后10min(T1)、20min(T2)以及放气后30min(T3)检测血气、血流动力学和血浆IL-6的变化。结果两组患者气腹后10min、20min利放气后30minPaO2和pH均有下降趋势,但与气腹前比较均无明显的统计学差异(P>0.05);气腹后10min、20min和放气后30minPaCO2均明显升高(P<0.05或P<0.01),两组PaCO2升高幅度无明显的统计学差异(P>0.05)。气腹后10min和20min对照组平均动脉压(MAP)和心率(HR)均明显升高(P<0.05或P<0.01),尼卡地平组MAP和HR均有上升趋势,但与气腹前比较均无明显的统计学差异(P>0.05),明显低于同时点对照组(P<0.05),放气后30min两组患者MAP,HR均恢复至气腹前水平。结论腹腔镜CO2气腹可引起患者高碳酸血症、心血管功能紊乱和应激反应,尼卡地平能有效地维持患者血流动力学的稳定,拮抗应激反应,稳定机体内环境作用。
出处 《海峡药学》 2010年第2期94-96,共3页 Strait Pharmaceutical Journal
基金 浙江省苍南县科技局课题资助项目
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