关键词: 腹腔镜手术, 二氧化碳气体栓塞, PaCO2-EtCO2差值

Abstract: ［Abstract］ Objective To investigate whether the PaCO2-EtCO2 gradient can be used as a diagnosis and evaluation indicator for carbon dioxide gas embolism in laparoscopic surgery. Methods 2 cases of carbon dioxide gas embolization during laparoscopic hepatectomy were retrospectively reviewed and related literature was reviewed. Results Two patients with gas embolism showed a slight decrease in SpO2 and a transient increase in end-tidal carbon dioxide （EtCO2）. One patient had a “mill-wheel” in the precordial region. The arterial blood gas analysis of two patients showed that the oxygenation index decreased while the partial pressure of carbon dioxide increased， and the PaCO2-EtCO2 gradient increased. After treatment， the oxygenation of the two patients improved， and the PaCO2-EtCO2 gradient decreased to the basal level. Conclusion Anesthesiologists should be alert to the occurrence of carbon dioxide gas embolism during the perioperative period. Arterial blood gas analysis can be used not only to assess the patient′s internal environment， but also to derive the PaCO2-EtCO2 gradient， which can be used for the diagnosis and efficacy evaluation of carbon dioxide gas embolism.

Key words: laparoscopic surgery, carbon dioxide gas embolism, PaCO2-EtCO2 gradient