The Infulence Of CO₂ Pneumoperitonum To Arterial Blood Gas And Hepatorenal Function In The Urological Laparoscopic Surgery In Qinghai Area

Objective:The paper aims to discuss the effects to the hepatorenal function by the CO₂ at different pneumoperitoneum pressures and time in retroperitoneoscope in Qinghai area.To evaluate the safety of retroperitoneoscope in Qinghai area,so as to direct the anesthesia and clinic.Methods:The patients who were cured in inpatient department of urinary surgery in Qinghai Provincial People's Hospital from May 2016 to October 2017 were selected.All of them were devideed into two groups.The one was high pneumoperitoneum pressure group?H group?with 55 patients which the pneumoperitoneum pressure in 14mmHg,the other with 50 patients in 11mmHg.All patients were finished the necessary inspections.And the data including PH,PaCO₂,PaO₂,SaO₂,HCO₃^-,ALT,AST,STB,Cr and BUN before the surgery were monitored.As well as dectecting the data of PH,PaCO₂,PaO₂,SaO₂ and HCO₃^-after the CO₂ was gived and ended 30min later.And remembering the results of ALT,AST,STB,Cr and BUN the first day,the third day and the seventh day of postoperation.Comparing the varieties of the data mentioned above at different time points under the same pressure.Adopting the spss 19.0 to analyse the data.Comparing the varieties of the data mentioned above under different pressures at the same time.Enumeration data are expressed by mean and standard.Different time pionts comparation in one group were compared by ANOVA for repeated measurement.T-test was used to contract the difference between the groups.It was considered significance in statistics when the probality less than 0.05.Results:The data of PH and PaCO₂ were significant difference when compared in T0and T1 in respective group,so did in T2 and T1.The PH in H group in T2 were lower than the results in T0?P<0.05?.However,the L group was not?P>0.05?.The PaCO₂ of the two groups in T2 had down but still higher than the T0?P<0.05?.Compared the PH between the two groups,there was no significant difference in statistics?P>0.05?.The PH of H group in T1 were lower than that L group and the PaCO₂ were higher?P<0.05?.Compared the PH and PaCO₂ of two group in T2,there was no significant difference in statistics?P>0.05?.The PaO₂ and SaO₂ in T1 of the two groups were higher than the resluts in T0?P<0.05?,but the T2 and T0 were not.Compared the results of PaO₂ and SaO₂ in the three time points,there was no significant difference in statistics?P>0.05?.Compared the data of HCO₃^-in each of group or between the two,there was no significant difference in statistics in one of the time point?P>0.05?.And so did the data of ALT,AST,Cr and BUN.The results of STB in T3 was significant difference compared with T0,T4,T5 in one group?P<0.05?,.but no significant difference out of the group?P>0.05?.There was no significant difference in STB between T0,T4 and T5 period?P>0.05?.Conclusions:1.It is relatively safety for the paients in Qinghai area who have lived here for a long time to have an retroperitoneal laparoscopic surgery within a certain range of CO₂pneumoperitoneum pressure,although at a special elevation.2.The Pneumoperitoneum pressure level may leads to have a acidosis when someone have an retroperitoneal laparoscopic surgery.So it is necessary to evaluate the renal and lung funtions before the surgery.We should pay a attention to the levels of the gas blood and the angpneumoperitoneum pressure during the surgery.3.It has a effect on the STB to patients who have an retroperitoneal laparoscopic surgery by the gas of CO₂,but subtle to the other indexs.So it is necessary to control the indications of operation to someone who have an weak liver funtion or a high level of STB.It also should pay a attention to the levels of STB in operation and the end.