摘要
目的:探讨腹腔镜胆总管切开取石"T"管引流术(laparoscopic choledocholithotomy T-tube drainage,LCTD)患者围手术期血流动力学的变化。方法:统计30例LCTD患者围手术期的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、中心静脉压(central venous pressure,CVP)及心电图(electrocardiogram,ECG)ST段的变化。结果:注气后HR高于气腹前,术中逐渐降低并稳定,解除气腹后同术前基本持平;气腹后MAP总体上呈增加趋势,解除气腹后逐渐回落,但基值仍高于术前;CVP气腹早期无明显变化,体位改为头高足低位后开始明显降低,解除气腹后逐渐趋于稳定,但未能恢复至术前水平;气腹前、气腹中ECG-ST段由无明显变化到逐渐抬高的趋势,解除气腹后逐渐恢复正常。结论:LCTD围手术期必须严密检测其血液动力学相关指标,及时发现异常变化并早期处理,以减少并发症的发生。
Objective：To summarize the changes of hemodynamics in the perioperative period of laparoscopie choledocholithotomy T-tube drainage（LCTD）. Methods：The perioperative data of 30 cases with LCTD were analyzed, including heart rate （HR） , the average artery pressure （mean arterial pressure ,MAP） ,the central venous pressure （CVP） and the electrocardiogram （ECG） ST section change. Results：HR was significantly high compared with pre-pneumoperitoneum, and descended during operation, then stabilized and equalled to preoperation. Compared with pre-pneumoperitoneum, MAP during operation was significantly high. It fell after deflation, but was still higher than pre-pneumoperitoneum. CVP had no significant change compared with pre-pneumoperitoneum, descended in a sloped head-high posture （about 15°-30°）, ascended after deflation. It was lower than pre-pneumoperitoneum. The ST section of ECG had no significant change compared with pre-pneumoperitoneum, and during operation decreased to normal after deflation. Conclusions： In the perioperative period of LCTD, patients＂ dynamics index should be strictly examined in order to reduce complications.
出处
《腹腔镜外科杂志》
2009年第1期59-61,共3页
Journal of Laparoscopic Surgery
基金
武警湖北总队2006年科研立项(200605)
