摘要
目的观察悬吊式腹腔镜胆囊切除术对循环和呼吸功能的影响。方法选择40例择期行腹腔镜胆囊切除术患者,随机分成悬吊式组(A组)和CO2气腹组(B组),各组20例。全身麻醉诱导均采用咪唑安定、芬太尼、丙泊酚、司可宁,麻醉维持采用吸入七氟醚,静脉泵入丙泊酚,间断静脉推注维库溴铵。记录诱导前基础值(T0)、气管插管后即刻(T1)、悬吊腹壁(或CO2气腹)5min(T2)、25min(T3)、停悬吊或气腹后(T4)、平均动脉压(MAP)、心率(HR)、血氧饱和度、呼气末二氧化碳分压(PETCO2)、气道峰压(Ppeak)的变化。结果与T0比较,A组MAP、HR轻度升高,差异无统计学意义(P>0.05);Ppeak轻度下降,与术前比较差异无统计学意义。B组MAP、HR、PETCO2、Ppeak明显升高,差异有统计学意义(P<0.05),也高于A组相应各个时点,差异有统计学意义(P<0.05)。结论悬吊式腹腔镜具有循环更稳定,呼吸更平衡等优点,更适宜心肺功能差的患者。
Objective To investigate the effects of suspended laparoscopic cholecystectomy on cardiopiclmonary function.Methods 40 patients,who were to be operated by means of laparoscopic cholecystectomy,were randomly divided into two groups：abdominal wall-lift method（group：A.n=20） and carbon dioxide pneumoperitoneum（group：B.n=20） .The anesthesia was introduced with midiazolam,fentanyl,propofel and succingl choline,and at the same time,they were continuously maintained with sevoflurane propofol and vecuronium,and their MAP and HR after moved into the operating theater（T0） ,immediately after endotracheal intubation（T1） and 5min.（T2） and 25min.after the beginning of the operation（T3） ,stop it（T4） were measured.Peak in spiratory airmay preassure（Ppeak） .SPO2 and PETCO2were recorded immediately after intubation and a minit later,gassless technique or carbon dioxide pneumopritioneum was conducted（T2） .Results Compared to T0,MAP and HR were a little bit higher in group A,with no significant difference（P〉0.05） .Ppeak in group A at T2and T3decreased compered to T1,while MAP HR PETCO2 and Ppeak in group B at T2and T3were higher than those in group A（P〈0.05） and also still higher than those in T1（P〈0.05） .Conclusion The advantages of the laparo scofirc cholecystectomy using abdominal wall-lifting method are much more stable in circulation and respiration.It is much more suitable to the patients with cardiopulmonary function trouble.
出处
《检验医学与临床》
CAS
2010年第21期2315-2316,共2页
Laboratory Medicine and Clinic
关键词
悬吊式腹腔镜
循环
呼吸
suspended laparoscopic
cholecystectomy circulatory function
respiratery function
