摘要
目的探讨麻醉诱导期呼气末正压通气对腹腔镜子宫肌瘤剔除术后患者呼吸功能的影响。方法选取台山市人民医院妇科2017年5月-2018年4月收治的行腹腔镜子宫肌瘤剔除术的子宫肌瘤患者60例,随机分为对照组与试验组,每组30例。对照组患者在术中行呼气末正压通气,试验组患者在麻醉诱导期行呼气末正压通气。比较两组患者气腹完成时,气腹0.5、1.0、1.5 h及放气时呼气末二氧化碳差值(Pa-ETCO2)、氧合指数(OI)以及肺泡动态顺应性。结果气腹完成时两组Pa-ETCO2、肺泡动态顺应性比较,差异无统计学意义(P>0.05);气腹0.5、1.0、1.5h及放气时试验组Pa-ETCO2低于对照组,肺泡动态顺应性高于对照组(P<0.05)。气腹完成时、气腹0.5 h两组OI比较,差异无统计学意义(P>0.05),气腹1.0、1.5 h及放气时试验组OI高于对照组(P<0.05)。结论腹腔镜子宫肌瘤剔除术患者在麻醉诱导期行呼气末正压通气可有效预防术后高二氧化碳血症、低氧血症的发生,改善呼吸功能,对提升手术安全性和临床疗效具有积极意义。
Objective To investigate the effect of positive end-expiratory pressure ventilation on respiratory function after laparoscopic myomectomy during anesthesia induction.Methods A total of 60 cases of patients with uterine leiomyoma were selected from May 2017 to April 2018 in the Department of Gynecology of Taishan People’s Hospital,which were randomly divided into control group and experimental group,30 cases in each group.The control group were given positive end-expiratory pressure ventilation during the operation,while the experimental group were given positive end-expiratory pressure ventilation during the induction period of anesthesia.The difference of Pa-ETCO2,OI and alveolar dynamic compliance at pneumoperitoneum completion,pneumoperitoneum 0.5,1.0,1.5 h and ventilation were compared between the two groups.Results There was no significant difference in Pa-ETCO2 or alveolar dynamic compliance between the two groups at pneumoperitoneum completion(P>0.05);the experimental group of Pa-ETCO2 was lower than the control group at pneumoperitoneum 0.5,1.0,1.5 h and ventilation,and alveolar dynamic compliance was higher than the control group(P<0.05).There was no significant difference in OI between the two groups at pneumoperitoneum completion and 0.5 h after pneumoperitoneum(P>0.05).the experimental group of OI at pneumoperitoneum 1.0,1.5 h and ventilation time was higher than the control group(P<0.05).Conclusion Positive end-expiratory pressure ventilation during anesthesia induction period can effectively prevent the occurrence of hypercapnia and hypoxemia after laparoscopic myomectomy,improve respiratory function,and have positive significance for improving the safety and clinical efficacy of surgery.
作者
谭洪光
伍元川
孙春红
黄健香
方海腾
TAN Hong-guang;WU Yuan-chuan;SUN Chun-hong(Taishan People's Hospital,Taishan 529200,China)
出处
《临床合理用药杂志》
2019年第30期19-20,22,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
平滑肌瘤
麻醉诱导期
呼气末正压通气
腹腔镜
呼吸功能
Leiomyoma
Induction period of anesthesia
Positive end-expiratory pressure ventilation
Laparoscopy
Respiratory function
