中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
17期
13-15
,共3页
麻醉方法%腹腔镜妇科手术%CO2气腹%呼吸循环功能
痳醉方法%腹腔鏡婦科手術%CO2氣腹%呼吸循環功能
마취방법%복강경부과수술%CO2기복%호흡순배공능
Anesthesia%Laparoscopic gynecologic surgery%CO2 pneumoperitoneum%Respiratory and circulatory function
目的：探讨不同麻醉方法对腹腔镜妇科手术CO2气腹对呼吸与循环功能的影响。方法整群选取该院2013年5月-2014年8月收治的92例腹腔镜妇科手术患者为研究对象,乱数表法随机分成A、B两组，每组46例。 B组采用插管全麻，A组则采用腰麻联合硬膜外麻醉方案完成麻醉。记录各时间点两组患者血流动力学指标变化及呼吸功能指标变化情况。结果①A组气腹前各血流动力学指标与气腹后(T2、T3)、排气后指标对比差异无统计学意义(P>0.05)，B组气腹前后各血流动力学指标对比差异有统计学意义(P<0.05)；②气腹前后，两组患者血氧饱和度对比差异无统计学意义(P>0.05)，呼气末二氧化碳分压对比差异有统计学意义(P<0.05)；B组气腹前后潮气量气道压对比差异有统计学意义(P<0.05)。结论腰-硬联合麻醉方案应激反应更小，血流动力学波动平缓，对腹腔镜妇科手术CO2气腹患者呼吸循环功能影响较低，值得临床推广。
目的：探討不同痳醉方法對腹腔鏡婦科手術CO2氣腹對呼吸與循環功能的影響。方法整群選取該院2013年5月-2014年8月收治的92例腹腔鏡婦科手術患者為研究對象,亂數錶法隨機分成A、B兩組，每組46例。 B組採用插管全痳，A組則採用腰痳聯閤硬膜外痳醉方案完成痳醉。記錄各時間點兩組患者血流動力學指標變化及呼吸功能指標變化情況。結果①A組氣腹前各血流動力學指標與氣腹後(T2、T3)、排氣後指標對比差異無統計學意義(P>0.05)，B組氣腹前後各血流動力學指標對比差異有統計學意義(P<0.05)；②氣腹前後，兩組患者血氧飽和度對比差異無統計學意義(P>0.05)，呼氣末二氧化碳分壓對比差異有統計學意義(P<0.05)；B組氣腹前後潮氣量氣道壓對比差異有統計學意義(P<0.05)。結論腰-硬聯閤痳醉方案應激反應更小，血流動力學波動平緩，對腹腔鏡婦科手術CO2氣腹患者呼吸循環功能影響較低，值得臨床推廣。
목적：탐토불동마취방법대복강경부과수술CO2기복대호흡여순배공능적영향。방법정군선취해원2013년5월-2014년8월수치적92례복강경부과수술환자위연구대상,란수표법수궤분성A、B량조，매조46례。 B조채용삽관전마，A조칙채용요마연합경막외마취방안완성마취。기록각시간점량조환자혈류동역학지표변화급호흡공능지표변화정황。결과①A조기복전각혈류동역학지표여기복후(T2、T3)、배기후지표대비차이무통계학의의(P>0.05)，B조기복전후각혈류동역학지표대비차이유통계학의의(P<0.05)；②기복전후，량조환자혈양포화도대비차이무통계학의의(P>0.05)，호기말이양화탄분압대비차이유통계학의의(P<0.05)；B조기복전후조기량기도압대비차이유통계학의의(P<0.05)。결론요-경연합마취방안응격반응경소，혈류동역학파동평완，대복강경부과수술CO2기복환자호흡순배공능영향교저，치득림상추엄。
Objective To investigate the effect of different anesthesia on respiratory and circulatory function of patients using CO2 pneumoperitoneum in gynecologic laparoscopic surgery. Methods 92 patients who received laparoscopic gynecologic surgery in our hospital in recent 1 year were selected as the research object and randomly divided into A, B two groups, 46 patients in each group. Intubation anesthesia was used in group B, while combined spinal and epidural anesthesia was conducted in group A. Changes in hemodynamics and respiratory function of two groups were recorded. Results① A group gas chest each hemodynamic indexes and pneumothorax (T2,T3), exhaust after index comparison was not statistically significant (P>0.05), B group before and after pneumothorax contrast dynamic index of each blood significantly (P<0.05); ② pneumothorax, two groups of patients blood oxygen saturation had no significantly difference (P>0.05), divided pressure contrast markedly end tidal carbon dioxide (P<0.05);B group before and after pneumothorax tidal volume airway pressure differences obviously (P<0.05). Conclusion With lower stress and steady hemodynamics, combined spinal epidural anesthesia has low impact on respiratory and circulatory function of patients using CO2 pneumoperitoneum in gynecologic laparoscopic surgery, so it is worth the clinical promotion.
