摘要
目的探讨妇科腔镜手术中脑血流量的变化对术后恶心呕吐(PONV)的影响。方法选择2015年11月—2017年6月在本院择期行妇科腔镜手术患者60例作为研究对象,随机数表法均分为G组和C组两组,每组各30例。G组:术前30 min静脉滴注0.5 g/kg甘露醇;C组:术前30 min静脉只给等容量等速度的生理盐水。采用无创多普勒超声测量入手术室5 min(T 1)、喉罩置入5 min(T 2)、气腹体位变化即刻(T 3)、气腹体位变化后30 min(T 4)、关气腹体位变化后即刻(T 5)、关气腹体位恢复后10 min(T 6)各时间点的双侧颈内动脉和椎动脉血管阻力指数,并计算脑血流量(cerebral blood flow volume,CBFV)。记录术后24 h内患者PONV的发生率及严重程度。结果术后24 h内,G组PONV的人数为9例(30.0%),明显少于C组17例(56.7%)(P<0.05),两组PONV的严重程度差异无统计学意义(P>0.05)。两组患者双侧椎动脉和双侧颈总动脉的血管阻力指数差异有统计学意义(P<0.05);与T 1相比,T 3~T 6时两组双侧颈内动脉和椎动脉血管阻力指数均增大,在T 4~T 6时点,G组双侧颈内动脉和椎动脉血管阻力指数显著低于C组(P<0.05)。两组患者CBFV差异无统计学意义(P>0.05),与T 1相比,T 3时两组CBFV显著增多(P<0.05);在T 4时,G组CBFV显著高于C组(P<0.05)。结论妇科腔镜手术中,脑动脉血流量的变化不影响PONV;椎动脉和颈内动脉的循环阻力增大,可使PONV的发生增加。甘露醇能预防妇科腔镜手术PONV的发生。
Objective To investigate the influence of cerebral blood flow volume on the incidence of postoperative nausea and vomiting(PONV)in patients undergoing gynecological laparoscopic surgery.Methods Sixty patients those who would underwent gynecological endoscopic surgery during November 2015 and June 2017 were enrolled as study subjects and were divided into two groups according to random number table method(n=30 in each group):group G and group C.The patients in group G were treated with infusion of 0.5g/kg mannitol 30 minutes before gynecological endoscopic surgery,and the patients in group C were treated with equal volume of saline.The vascular resistance indexes(RI)of bilateral internal carotid artery and vertebral artery were measured by ultrasound at 5 minutes after entering the operating room(T 1),5 minutes after insertion of the laryngeal mask(T 2),immediately after the position change of the pneumoperitoneum(T 3),30 minutes after the position change of the pneumoperitoneum(T 4),immediately after the position change of the pneumoperitoneum(T 5),and 10 minutes after the recovery of the closed position of the abdomen(T 6)and calculated the cerebral blood flow volume(CBFV).The incidence and severity of postoperative nausea and vomiting within 24 hours after surgery were recorded.Results Within 24 hours after operation,the incidence of PONV in group G(9,30.0%)was significantly lower than group C(17,56.7%)(P<0.05).However,there was no statistical difference in the severity of PONV between the two groups(P>0.05).The RI of bilateral vertebral artery and bilateral common carotid artery were statistically different between the two groups(P<0.05).Compared with T 1,the RI of both internal carotid and vertebral arteries were increased in both groups at T 3~T 6.The RI of internal carotid artery and vertebral artery in group G was significantly lower than group C at T 4~T 6(P<0.05).There was no statistical difference in CBFV between the two groups(P>0.05).Compared with T 1,the CBFV of the group G and C significantly increa
作者
程慧娴
李高杰
丁杰
郭文俊
CHENG Hui-xian(Department of anesthesiology,Yijishan hospital of Wannan Medical College,Wuhu,Anhui,241001,China)
出处
《齐齐哈尔医学院学报》
2020年第17期2189-2191,共3页
Journal of Qiqihar Medical University
关键词
腹腔镜手术
脑血流量
术后恶心呕吐
Laparoscopic surgery
Cerebral blood flow volume
Postoperative nausea and vomiting
