Objective To investigate the positive end expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2 ) minimally invasive laparoscopic surgery for uterine fibroids in patients with arterial‐end‐tidal carbon dioxide partial pressure difference [D(a‐ET ) CO2 ] impact .Methods Sixty‐eight cases of laparoscopic uterine fi‐broids patients of ASA grade Ⅰ‐Ⅱ were underwent elective surgery for the study from June 2012 to June 2014 . The patient ventilation conditions were divided into three groups ,A group of 22 cases :PEEP 0 ,pure oxygen ven‐tilation;group B 20 cases:PEEP is 0 ,FiO2 50% ,empty oxygen mixture mechanical ventilation;26 cases of group C :PEEP of 5 cmH2 O ,FiO2 50% ,empty oxygen mixed gas machinery ventilation .Comparative analysis of three groups of patients immediately after intubation (T1 ) ,pneumoperitoneum 30 min (T2 ) and pneumoperitone‐um 60 min (T3 ) at the rate of pulmonary shunt (Qs/Qt) ,D(a‐ET ) CO2 differences .Results The levels of Qs/Qt ,D(a‐ET) CO2 of T1 times of A ,B ,C were no significant difference ( P >0 .05) .The levels of Qs/Qt ,D(a‐ET) CO2 of groups A and group B ,groups B and group C ,group A and group C of T2 ,T3 times ,difference were statistically significant ( P<0 .05) .Conclusion PEEP is 5 cmH2O ,increase FiO2 concentration can effectively re‐duce uterine fibroids laparoscopic patients D(a‐ET ) CO2 ,increase PaCO2 levels ,reduce pulmonary shunt .%目的：探讨呼气末正压（PEEP）及吸入氧浓度（FiO2）对子宫肌瘤腹腔镜微创手术患者动脉血‐呼气末二氧化碳分压差[D（a‐ET ） CO2]的影响。方法选取本院2012年6月至2014年6月收治的68例行择期手术的美国麻醉医师协会（ASA ）分级Ⅰ～Ⅱ级腹腔镜子宫肌瘤患者为研究对象，根据患者通气条件分为3组，A组22例：PEEP为0，纯氧机械通气；B组20例：PEEP为0，FiO250％，空氧混合气体机械通气；C组26例：PEEP为5 cmH2O（1 cmH2O＝0.098 kPa），FiO250％，空氧混合气体机械通气。对比分析3组患者气管插管后即刻（T1）、气腹30 min（T2）及气腹60 min（T3）时肺内分流率（Qs／Qt）、D（a‐ET）CO2的差异。结果在 T1时3组Qs／Qt、D（a‐ET）CO2差异无统计学意义（ P ＞0.05），T2、T3时A组与B组、B组与C组、A组与C组相比，Qs／Qt、D（a‐ET） CO2差异有统计学意义（ P ＜0.05）。结论 PEEP为5 cmH2O ，提高FiO2浓度能有效降低子宫肌瘤腹腔镜患者D（a‐ET ）CO2，提高动脉血二氧化碳分压（PaCO2）水平，减少肺内分流。
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