| Objective: During laparoscopic surgery is developing in and out of the nation ,pneumoperitoneum's effect on organism which on respiration system and circulation system is the most important makes many scholar s' attention .At present CO2 has become the most popular media of insufflation clinically ,but it can cause more serious respiratory acidosis pneumoperitoneum pressure is the most important condition that can make laparoscopic operation succeed. The lower pneumoperitoneum pressure cannot provide enough operation space, but the higher pressure that can cater to operation can make an effect on respiratory and circulation's system by elevating diaphragm, pressing the ateria and vena in abdomen ,and making CO2 absorbed by abdominal membrane . The change of respiratory and circulation system around pneumoperitoneum is the content of resent most investigations, but there aren't many elaborate investigations on the change of respiratory and circulation system on the condition of variable pneumoperitoneum pressure. The investigation want to discuss the effect of variable CO2 pneumoperitoneum pressure on respiratory and circulation system in laparoscopic operations by measuring respiratory and circulation system's parameters and arterial blood gas analysis on the condition of 10 mmHg and 15 mmHg pressure, observing complications during and after operation.Method: Sixty patients under going laparoscopic cholecystectomy were divided into tow groups on the basis of low and highpneumoperitoneum pressure. Respiration and circulation system parameters and arterial blood gas analysis were measured before and after CO2 being insufflation into peritoneal cavity and their changes were observing to compare all parameters at every times.Result: (1) The changes of respiration and blood gas analyze: Airway pressure of two groups increased significantly after creation of pneumoperitoneum, which of HP group was more significantly , and returned to the level of prepneumoperitoneum. Pulmonary compliance of two groups decreased significantly after creation of pneumoperitoneum, which of HP group was more significantly, and they returned to the level of prepneumoperitoneum after pneumoperitoneum. End tidal CO2 pressure of two groups increased significantly after creation of pneumoperitoneum, which of HP group was higher than LP group. PH of two groups decreased after creation of pneumoperitoneum, which of HP group was lower than LP during pneumoperitoneum. Five minutes after the end of pneumoperitoneum pH of LP group returned to the level of prepneumoperitoneum, but pH of HP group was significantly lower than the level of prepneumoperitoneum and 7.35. The CO2 arterial pressure of two groups increased after creation of pneumoperitoneum, and they both were higher than 45 mmHg, five minutes after prepneumoperitoneum which of LP group returned and which of HP group was higher than the level of prepneumoperitoneum. O2 arterial pressure of two groups remained unchanged after creation of pneumoperitoneum. Arterialoxygen saturation, pulse oxygen saturation, actual base excess and standard base excess of two groups didn't change significantly after creation of pneumoperitoneum. (2) The changes in circulation system: Heart rates of two groups both increased, but HP group increased more significantly and they returned at post peumoperitoneum. Diastolic blood pressure, systolic blood pressure and mean arterial pressure of two groups all increased, which of HP group increased more significantly and didn't return to the level of prepneumoperitoneum, but LP group did. Central venous pressure of two groups both increased significantly after creation of pneumoperitoneum, which of HP group increased more significantly, and returned at post pneumoperitoneum. Systemic vascular resistance of two groups increased significantly after creation of pneumoperitoneum, and return to the level of prepneumoperitoneum gradually. Stroke volume of two groups didn't change significantly. Cardiac output and cardiac index of two groups both in...
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