张建云, 肖春花. 乳腺腔镜手术的围手术期血气动态监测临床分析[J]. 中国肿瘤临床, 2023, 50(12): 621-625. DOI: 10.12354/j.issn.1000-8179.2023.20221733
引用本文: 张建云, 肖春花. 乳腺腔镜手术的围手术期血气动态监测临床分析[J]. 中国肿瘤临床, 2023, 50(12): 621-625. DOI: 10.12354/j.issn.1000-8179.2023.20221733
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Jianyun Zhang, Chunhua Xiao. Clinical analysis of perioperative blood gas dynamic monitoring in breast endoscopic surgery[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 621-625. DOI: 10.12354/j.issn.1000-8179.2023.20221733
Citation: Jianyun Zhang, Chunhua Xiao. Clinical analysis of perioperative blood gas dynamic monitoring in breast endoscopic surgery[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 621-625. DOI: 10.12354/j.issn.1000-8179.2023.20221733
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乳腺腔镜手术的围手术期血气动态监测临床分析

Clinical analysis of perioperative blood gas dynamic monitoring in breast endoscopic surgery

    摘要
  • 摘要:
      目的  探讨乳腺良、恶性肿瘤患者在CO2气体建腔情况下行乳腺腔镜手术过程中CO2气腔对围手术期血气参数的影响，为乳腺腔镜手术的安全性提供参考。
      方法  选取2022年3月至2022年9月就诊于天津医科大学肿瘤医院行乳腺腔镜手术的良、恶性乳腺肿瘤患者35例，于术前（CO2充气前）、术中（CO2充气后60 min）、术后（麻醉苏醒后30 min）分别抽取患者桡动脉血，并采用统计学方法对酸碱度（pH值）、动脉二氧化碳分压（pCO2）、剩余碱正负值（±BE）、碳酸氢根离子（HCO3−）血气指标变化情况，及各指标之间的相关性进行分析。
      结果  35例患者术中pCO2均较术前升高，术后均下降至术前水平。t检验显示，术中与术前相比，pCO2和HCO3−显著增加（t=−7.196和t=−4.709，均P<0.05）、pH值显著下降（t=7.069，P<0.05)，BE正值增加（t=−1.924，P>0.05）；术后与术前相比，pCO2、pH值、HCO3−均无明显变化（t=0.141、t=1.170、t=1.622，均P>0.05），BE负值增加（t=1.830，P>0.05)。Pearson相关性分析显示，患者术中pCO2变化与pH值及HCO3−变化具有相关性（r=0.423及r=0.769，均P<0.05），±BE与HCO3−变化亦具有相关性（r=0.678，P<0.05）。
      结论  在CO2气体建腔下，乳腺腔镜手术对患者的围手术期血气分析指标有一定影响，但术后患者麻醉清醒后可恢复至术前水平，安全可靠，值得广泛推广。

     

    Abstract:
      Objective  To investigate the effect of endoscopic breast reconstruction surgery under CO2 gas chamber on the perioperative blood gas parameters of patients with benign and malignant breast tumors and to ensure its safety.
      Methods  A total of 35 patients with benign and malignant breast tumors who underwent breast endoscopic surgery at Tianjin Medical University Cancer Institute & Hospital between March 2022 and September 2022 were selected. Blood was collected from the patients’ radial artery preoperatively (before CO2 aeration), during surgery (60 min after CO2 aeration), and postoperatively (30 min after anesthesia recovery). The changes in blood gas indices, including pH, arterial partial pressure of carbon dioxide (pCO2), residual alkali (±BE), and bicarbonate ion (HCO3-) and the correlations among them were analyzed statistically.
      Results  The intraoperative levels of pCO2 increased compared to the preoperative levels, while the postoperative levels of pCO2 reduced to the preoperative levels. Results from the t-test showed that the measurements of intraoperative pCO2 and HCO3− significantly increased compared with those postoperatively (t =−7.196, t =−4.709, all P<0.05). The pH value significantly decreased (t=7.069, P<0.05), and the positive BE value increased (t=−1.924, P>0.05). No significant changes in the preoperative measurements of pCO2, pH, and HCO3− relative to those postoperatively were observed (t=0.141, t=1.170, t=1.622, all P>0.05), while the negative BE value increased (t=1.830, P>0.05). Results from the Pearson correlation showed that the changes in pCO2 during surgery were correlated with the changes in pH and HCO3− (r=0.423, r=0.769, all P<0.05), while BE was correlated with HCO3− (r=0.678, P<0.05).
      Conclusions  Endoscopic breast reconstruction surgery under CO2 gas chamber impacted the patients’ perioperative blood gas analysis indices; however, the measurements returned to preoperative levels after recovery from anesthesia. Our findings suggest that endoscopic breast surgery under CO2 gas chamber reconstruction is safe and reliable, and thus, should be promoted.

     

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