Ventilatory Effects of Laparoscopic Cholecystectomy Using Abdominal Wall Lift

應用腹壁提起方式（Abdominal Wall Lift）作腹腔鏡膽囊切除（Laparoscopic Cholecystectomy）對於換氣功能的影響

徐智星(Chi-Sing Hsu) ； 葉富欽(Fuh-Cheng Yeh) ； 褚錦承(Chin-Chen Chu) ； 謝介平(Ja-Ping Shieh)

《慈濟醫學雜誌》 12卷3期 (2000/09) Pp. 149-152

https://doi.org/10.6440/TZUCMJ.200009.0149

摘要

目的：評估應用腹壁提起方式作腹腔鏡膽囊切除對於換氣功能的影響。病人及方法：本臨床研究包括13位預備接受腹腔鏡膽囊切除患者，以pentothal、fentanyl作麻醉誘導；麻醉維持使用藥物為isoflurane、N2O、atracurium。腹腔鏡手術應用提起壁方式（一種新的機械式腹腔鏡方法）幫忙完成。麻醉中人工呼吸器潮氣容積設定為10mL/kg與10bpm。手術中於各個階段監測呼吸氣體（end-tidal CO2，動脈血氧飽和度）及換氣功能的變數（compliance of total respiratory system, peak and plateau airway pressures, expiratory tidal volume）結果：於提起腹壁前後及放鬆腹壁後end-tidal CO2與各種換氣功能的變數全都沒有明顯變化。整個手術過程動脈血氧飽度也都維推在100%/ 結論：應用腹壁提起方式作腹腔鏡膽囊切除對於換氣功能沒有明顯的影響。

關鍵字

Respiratory mechanics ； 腹腔鏡腹壁提起方式

並列摘要

Objective: To evaluate changes of respiratory mechanics during laparoscopic cholecystectomy using abdominal wall lift. Patients and Methods: This clinical study included 13 patients scheduled for laparoscopic cholecystectomy. Anesthesia was induced with fentanyl and pentothal, maintained with isoflurane and N2O in O2 (50%). Laparoscopy was performed with abdominal wall lift, a mechanical method of laparoscopy. Tidal volume was set at 10 mL/kg with a rate of 10bpm during anesthesia. Respiratory gases and ventilatory variables, including compliance of the total respiratory system, peak and plateau airway pressures, and expiratory tidal volume, were monitored. Results: The end-tidal CO2 tension and ventilatory variables did not change significantly between before and after establishment of the abdominal wall lift, and after release of the abdominal wall left. Arterial O2 saturation was well maintained at 100% throughout the entire course of surgery. Conclusions: Laparoscopic cholecystectomy using abdominal wall lift does not disturb respiratory mechanics.

並列關鍵字

respiratory mechanics ； laparoscopy ； abdominal wall lift