Forecast value of repiratory frequency and tidal volume for changes of CO2 pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy

doi:10.3877/cma.j.issn.2095-655X.2014.01.011

Abstract

Abstract:

Objective

To study the effects of repiratory frequency and tidal volume for CO₂ pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy.

Methods

Forty-two patients were divided into group A(f=12, Vt=9ml/kg, n=22) and group B(f=14, Vt=7ml/kg, n=20). PPEAK, P_ETCO₂ and pHi were monitored before pneumoperitoneum (T1) 20min after pneumoperitoneum (T2) and relieving pneumoperitoneum (T3) respectively.

Results

PPEAK, P_ETCO₂ at T2 were significantly higher than that at T1 in the same groups (P<0.05). pHi of B group at T2 was significantly lower than that at T1(P<0.05). There were significant difference of T2 indexes in group A compared with group B(P<0.05).

Conclusion

The method of proper frequency rate and tidal volume in CO₂ pneumoperitoneum may act positively for respiratory system and pHi of aged patients during laparoscopic cholecystectomy .

Key words: Gastric mucosa, Hydrogenion concentration, Aged patients, Pneumoperitoneum, artificial, Cholecystectomy, laparoscopic

Xinfeng Li, Ran Li, Gaoxiong Wang, Tiancong Huang. Forecast value of repiratory frequency and tidal volume for changes of CO2 pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy[J]. Chinese Journal of Diagnostics(Electronic Edition), 2014, 02(01): 55-57.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2014.01.011

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2014/V02/I01/55

Figures/Tables 2

References 11

[1]	李文忠,张志春,田兴荣. 高龄患者胆囊切除风险和围手术期处理[J]. 中华肝胆外科杂志, 2010, 16(9): 701-702.
[2]	杨志寅. 现代医学科学发展中的缺憾与思考[J]. 中华诊断学电子杂志, 2013, 1(1): 1-7.
[3]	Eleftheriadis E,kotzampassi k,Botsios D, et al.Splanchnic ischemia during laparo-scopic cholecystectomy[J]. Surg Endoscopy, 1996, 10(3): 324-327.
[4]	Fiddian-Green RG.Gastric intramucosal pH, tissue oxygenation and acidbase balance[J]. Br J Anaesth, 1995, 74(5): 591-595.
[5]	冯梅,蒋宗滨. 二氧化碳气腹对围手术期呼吸功能的影响[J]. 微创医学, 2007, 2(3): 214-216.
[6]	Schmalstieg FC,Keeney SE,Rudloff HE, et al.Arteriovenous CO₂ removal improves survival compared to high frequency percussive and low tidal volume ventilation in a smoke/burn sheep acute respiratory distress syndrome model[J]. Ann surg, 2007, 246(3): 512-521.
[7]	Mascia L,Zavala E,Bosma K, et al.High tidal volume is associated with the development of acute lung injury after severe brain injury：an international observational study[J]. Crit Care Med, 2007, 35(8), 1815-1820.
[8]	杨云丽,解云,魏辉明, 等. 腹腔镜胆囊切除术对老年患者胃黏膜PH值的影响[J]. 昆明医学院学报, 2005, 26(2)；103-105.
[9]	侯百东. 胃黏膜内pH (pHi)值测定及其临床意义[J]. 国外医学外科学分册, 1997, 24 (2): 84.
[10]	黄凤贞,唐宏. CO₂气腹及体位对呼吸循环功能的影响[J]. 中国实用医药, 2008, 3(20): 21-22.
[11]	滕延鹏. 腹腔镜胆囊切除术治疗老年急性胆囊炎的临床疗效及安全性评价[J]. 中国普通外科杂志, 2013, 22(2): 250-252.

组别	例数	体质量(kg)	手术时间(min)	输入液体量(ml)
A组	22	58.2±1.2	65.3±3.7	632.3±7.5
B组	20	57.4±2.3	66.1±2.2	635.2±2.1
t值	?	1.43	0.84	1.67
P值	?	0.16	0.41	0.10

组别	例数	体质量(kg)	手术时间(min)	输入液体量(ml)
A组	22	58.2±1.2	65.3±3.7	632.3±7.5
B组	20	57.4±2.3	66.1±2.2	635.2±2.1
t值	?	1.43	0.84	1.67
P值	?	0.16	0.41	0.10

组别	例数	PPEAK					P_ETCO₂					pHi
组别	例数	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值
A组	22	14.65±1.76	25.68±2.61	15.05±1.77	198.043	0.000	28.72±1.68	35.68±1.61	29.05±1.73	121.034	0.000	7.39±0.06	7.08±0.08	7.30±0.05	132.176	0.000
B组	20	14.96±1.89	22.03±4.12	14.97±1.89	41.391	0.000	28.65±1.81	33.09±1.12	28.97±1.54	53.303	0.000	7.40±0.01	7.26±0.05	7.37±0.03	93.143	0.000
t值	?	1.15	3.46	1.14	?	?	1.16	5.99	1.26	?	?	1.44	8.64	2.78	?	?
P值	?	>0.05	<0.05	>0.05	?	?	>0.05	<0.05	>0.05	?	?	>0.05	<0.05	<0.05	?	?

组别	例数	PPEAK					P_ETCO₂					pHi
组别	例数	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值	气腹前(T1)	气腹后20min(T2)	放气后20min(T3)	F值	P值
A组	22	14.65±1.76	25.68±2.61	15.05±1.77	198.043	0.000	28.72±1.68	35.68±1.61	29.05±1.73	121.034	0.000	7.39±0.06	7.08±0.08	7.30±0.05	132.176	0.000
B组	20	14.96±1.89	22.03±4.12	14.97±1.89	41.391	0.000	28.65±1.81	33.09±1.12	28.97±1.54	53.303	0.000	7.40±0.01	7.26±0.05	7.37±0.03	93.143	0.000
t值	?	1.15	3.46	1.14	?	?	1.16	5.99	1.26	?	?	1.44	8.64	2.78	?	?
P值	?	>0.05	<0.05	>0.05	?	?	>0.05	<0.05	>0.05	?	?	>0.05	<0.05	<0.05	?	?

[1]	Caiyun Zhang, Zewei Zhang, Yunxiang Qiu, Jiajie Fan, Zhijie Zheng. Relationship between early gastric mucosal pH and cardiac function in infants with congenital heart disease undergoing cardiopulmonary bypass [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(01): 28-33.
[2]	Fulin Li, Xue Li, Dairong Peng. Histological changes of gastric mucosa and Helicobacter pylori infection status in patients after operation due to benign or malignant gastric diseases [J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(03): 253-257.
[3]	Pinghui Shi, Li Liu. Clinical study on treatment of Helicobacter pylori infection related chronic gastritis by modified Chaihu shugan powder combined with Helicobacter pylori eradication program [J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(05): 496-499.
[4]	Juan-juan ZHANG, Wen-kui YU, Jia-liang SHI, Tao GAO, Feng-chan XI, Wei-ming ZHU, Ning LI. Effects of fluid restriction on perioperative plasma aldosterone for the aged patients [J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(05): 354-357.
[5]	Jun-jie SUN, Zhe XU, Zhi-chong ZHANG, Jun-cheng LIU, Jia-cong MO. Meckel′s diverticulum in children: clinical analysis of 27 cases [J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(03): 243-245.
[6]	Desheng Wang, Qingjie Su, Faqing Long, Xiangdong Zhou, Jie Wang. Effects of acid suppressive drugs on common complications in patients with posterior circulation acute cerebral infarction [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(04): 415-419.
[7]	Wei Li, Xiaoli Chen, Rensong Cai, Li Zhu, Suting Yan, Xiaoli Xing. Diagnostic value of gastric mucosal morphology changes detected by white light gastroscopy in Helicobacter pylori infection [J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(02): 152-156.
[8]	Jiao Lin, Enuo Peng, Hongzhu Liu, Yunshan Jiang, Xianghong Huang. Application of improved short protocol with gonadotropin-releasing hormone agonist and progestin primed ovarian stimulation in elderly patients with low ovarian reserve function [J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(08): 603-607.
[9]	Ronggui Zhang, Qianqian Chen, Qiyang Huang. The clinical study of puny mucosal prominence in the duodenal bulb [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2018, 05(02): 81-83.
[10]	Shuyi Zhang, Shusen Wang, Mo Dong, Lei Shi, Yanru Li, Wen Li. The study of prevention effect of esomeprazole on clopidogrel-induced gastric mucosal injury [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2018, 05(01): 38-40.
[11]	Minmin Chen, Songbai Zheng, Sheilesh Dewan. Change of aging on bioactive factors related to gastric mucosal defense-repair mechanisms [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2016, 03(04): 41-45.
[12]	Fei Liu, Songbai Zheng, Xiaoli Zhang, Xiaowen Li, Li Xiao, Zhang Yu. Age-related morphological changes in Beagles antral mucosa [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2014, 01(01): 15-18.
[13]	Jing Wang, Yongkang Wang, Ping Lu. Effects of stress on gastric mucosal inflammation and premature ovarian failure in female mice [J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2023, 10(02): 69-76.
[14]	Tengfei Hao, Weiwen Shi, Liang Li. Disscussion of the relation between the proximal esophgeal ectopic gastic mucosa and the gastroesophageal reflux [J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(02): 87-89.

Please choose a citation manager

Content to export