中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
33期
13-16
,共4页
印武%熊桂林%李国辉%黄启文
印武%熊桂林%李國輝%黃啟文
인무%웅계림%리국휘%황계문
腹腔镜%气腹%体位%血液动力学现象
腹腔鏡%氣腹%體位%血液動力學現象
복강경%기복%체위%혈액동역학현상
Laparoscopes%Pneumoperitoneum%Posture%Hemodynamic phenomena
目的 观察腹腔镜胆囊切除术(LC)与腹腔镜妇科诊治术(LP)中二氧化碳气腹、体位对血压、心率、脉搏血氧饱和度( SpO2)的影响.方法选择ASA分级Ⅰ～Ⅱ级行LC患者(LC组,12例)及LP患者(LP组,13例).予丙泊酚、芬太尼、恩氟烷、阿曲库铵维持麻醉与肌松,分别记录术前、充气后即刻、调整体位后、充气后30 min、放气后的收缩压、舒张压、心率、SpO2.结果LC组患者充气后即刻、调整体位后及充气后30 min收缩压、舒张压[收缩压:(138.75±13.22)、( 140.42±15.88)、( 138.67±16.35) mm Hg(1mm Hg =0.133 kPa);舒张压:(94.42±5.76)、(96.25±8.26)、(90.42±7.36) mm Hg]均较术前[收缩压:(135.50±15.31 )mm Hg;舒张压:(83.58±6.70) mmHg]升高(P＜0.01),LP组患者调整体位后及充气后30 min收缩压、舒张压[收缩压:(136.76±12.55)、(136.85±13.22) mm Hg;舒张压:(88.38±6.54)、(87.23±6.34) mm Hg]均较术前[收缩压:(132.52±10.11) mm Hg;舒张压:(74.61±5.23)mmHg]升高(P＜ 0.05)；两组各时间点心率、SpO2比较差异均无统计学意义(P＞0.05).结论LC与LP由于麻醉、体位、二氧化碳人工气腹的影响,在气腹后收缩压、舒张压均明显高于术前,但两者比较差异无统计学意义.
目的 觀察腹腔鏡膽囊切除術(LC)與腹腔鏡婦科診治術(LP)中二氧化碳氣腹、體位對血壓、心率、脈搏血氧飽和度( SpO2)的影響.方法選擇ASA分級Ⅰ～Ⅱ級行LC患者(LC組,12例)及LP患者(LP組,13例).予丙泊酚、芬太尼、恩氟烷、阿麯庫銨維持痳醉與肌鬆,分彆記錄術前、充氣後即刻、調整體位後、充氣後30 min、放氣後的收縮壓、舒張壓、心率、SpO2.結果LC組患者充氣後即刻、調整體位後及充氣後30 min收縮壓、舒張壓[收縮壓:(138.75±13.22)、( 140.42±15.88)、( 138.67±16.35) mm Hg(1mm Hg =0.133 kPa);舒張壓:(94.42±5.76)、(96.25±8.26)、(90.42±7.36) mm Hg]均較術前[收縮壓:(135.50±15.31 )mm Hg;舒張壓:(83.58±6.70) mmHg]升高(P＜0.01),LP組患者調整體位後及充氣後30 min收縮壓、舒張壓[收縮壓:(136.76±12.55)、(136.85±13.22) mm Hg;舒張壓:(88.38±6.54)、(87.23±6.34) mm Hg]均較術前[收縮壓:(132.52±10.11) mm Hg;舒張壓:(74.61±5.23)mmHg]升高(P＜ 0.05)；兩組各時間點心率、SpO2比較差異均無統計學意義(P＞0.05).結論LC與LP由于痳醉、體位、二氧化碳人工氣腹的影響,在氣腹後收縮壓、舒張壓均明顯高于術前,但兩者比較差異無統計學意義.
목적 관찰복강경담낭절제술(LC)여복강경부과진치술(LP)중이양화탄기복、체위대혈압、심솔、맥박혈양포화도( SpO2)적영향.방법선택ASA분급Ⅰ～Ⅱ급행LC환자(LC조,12례)급LP환자(LP조,13례).여병박분、분태니、은불완、아곡고안유지마취여기송,분별기록술전、충기후즉각、조정체위후、충기후30 min、방기후적수축압、서장압、심솔、SpO2.결과LC조환자충기후즉각、조정체위후급충기후30 min수축압、서장압[수축압:(138.75±13.22)、( 140.42±15.88)、( 138.67±16.35) mm Hg(1mm Hg =0.133 kPa);서장압:(94.42±5.76)、(96.25±8.26)、(90.42±7.36) mm Hg]균교술전[수축압:(135.50±15.31 )mm Hg;서장압:(83.58±6.70) mmHg]승고(P＜0.01),LP조환자조정체위후급충기후30 min수축압、서장압[수축압:(136.76±12.55)、(136.85±13.22) mm Hg;서장압:(88.38±6.54)、(87.23±6.34) mm Hg]균교술전[수축압:(132.52±10.11) mm Hg;서장압:(74.61±5.23)mmHg]승고(P＜ 0.05)；량조각시간점심솔、SpO2비교차이균무통계학의의(P＞0.05).결론LC여LP유우마취、체위、이양화탄인공기복적영향,재기복후수축압、서장압균명현고우술전,단량자비교차이무통계학의의.
Objective To investigate the influence of carbon dioxide pneumoperitoneum,posture on blood pressure,heart rate (HR),pulse oxygen saturation (SpO2) of laparoscopic cholecystectomy (LC)and gynecologic surgery (LP) patients.Methods Twelve LC patients (LC group)and 13 LP patients(LP group) with ASA Ⅰ - Ⅱ were selected.Anesthesia and muscle relaxation were maintained by propofol,fentanyl,enflurane,atracurium and the systolic pressure (SBP),diastolic pressure (DBP),HR,SpO2 was recorded in the following times:before anesthesia (T0),immediately after inflation (T1),after position adjustment (after 10 win inflation ) (T2),after 30 min inflation ( T3 ),after deflation (the end of operation)(T4).Results The SBP and DBP at T1,T2,T3 [SBP:(138.75 ± 13.22),(140.42 ± 15.88),(138.67 ±16.35) mm Hg( 1 mm Hg =0.133 kPa) ; DBP:(94.42 ± 5.76),(96.25 ± 8.26),(90.42 ± 7.36) mm Hg] was higher than that at T0[SBP:( 135.50 ± 15.31 ) mm Hg;DBP:(83.58 ± 6.70) mm Hg] in LC group(P＜ 0.01 ).The SBP and DBP at T2,T3 [SBP:(136.76 ± 12.55),(136.85 ± 13.22) mm Hg;DBP:(88.38 ±6.54),(87.23 ± 6.34) mm Hg ] was higher than that at T0 [ SBP:( 132.52 ± 10.11 )mm Hg; DBP:(74.61 ± 5.23 )mm Hg] in LP group (P ＜ 0.05 ).There was no significant difference in HR,SpO2 between T0 and the other points in two groups (P ＞ 0.05).Conclusion The hemodynamic changes have no significant difference between LC and LP;but compared with preoperative,the hemodynamic changes have significant difference after inflation.
