摘要: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 =9 ml/kg,n =22)and group B(f=14,Vt=7 ml/kg,n=20).PPEAK,PETCO2 and pHi were monitored before pneumoperitoneum (T1)20 min after pneumoperitoneum (T2)and relieving pneumoperitoneum (T3)respectively.Results PPEAK,PETCO2 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 .%目的:研究呼吸频率及潮气量在腹腔镜胆囊切除中CO2气腹对老年患者呼吸功能及胃黏膜pH值(pHi)的影响。方法42例腹腔镜胆囊切除CO2气腹的老年患者(≥65岁),在全麻CO2气腹压力为13 mmHg(1 mmHg=0.133 kPa),依术中呼吸频率、潮气量分为A、B组。A组22例(呼吸频率12次/min,潮气量9 ml/kg),B组20例(呼吸频率14次/min,潮气量7 ml/kg),分别于气腹前(T1)、气腹后20 min (T2)、气腹结束后20 min(T3)监测气道压力峰值(PPEAK)、呼气末CO2分压(PET CO2)及pHi值。结果 A、B两组在PPEAK、PET CO2及pHi参数方面各组组间T2同节点比较,差异有统计学意义[(分别为(25.68±2.61)mmHg,(22.03±4.12)mmHg;t =3.46,P <0.05;(35.68±1.61)mmHg,(33.09±1.12)mmHg;t =5.99,P <0.05;(7.08±0.08)mmHg,(7.26±0.05)mmHg;t =8.64,P <0.05]。结论使用适当的高通气频率、低潮气量通气方法,对CO2气腹腹腔镜胆囊切除老年患者的呼吸功能及胃黏膜pH值具有正向作用。