摘要
目的 探讨在腹腔镜胆囊切除术中气腹压的变化及对患者心脏循环效率的临床影响。方法 选择2020年1月至2021年12月期间在我院行腹腔镜胆囊切除术的患者中100例进行研究,根据气腹压大小进行分组,采用14 mmHg(1 mmHg=0.133 kPa)气腹压的患者纳入对照组(50例),采用10mmHg的患者纳入观察组(50例),对比2组的手术情况、术中不同阶段的血流动力学和动脉呼吸循环功能指标。结果 2组的手术时间、气腹时间、术中失血量差异均无统计学意义(P>0.05);观察组的肠道排气时间和进食时间分别为[(2.9±0.3)d]、[(3.5±0.6)d],均短于对照组的[(4.4±3.0)d、(4.5±2.8)d](P<0.05);观察组在气腹建立即刻(T1)、气腹建立15 min后(T2)、和术后30 min(T3)的平均动脉压(MBP)、心率和心脏循环效率(CCE)分别为(89±9)mmHg、(92±10)mmHg、(90±9)mmHg、(106±11)次/min、(114±11)次/min、(103±9)次/min、(-0.43±0.11)、(-0.84±0.73)、(0.28±0.12),均低于对照组的(94±10)mmHg、(99±10)mmHg、(95±9)mmHg、(112±12)次/min、(122±12)次/min、(110±11)次/min、(-0.61±0.35)、(-0.52±0.25)、(0.14±0.27)(P<0.05);观察组在T1、T2、和T3的氧分压(PaO_(2))和二氧化碳分压(PaCO_(2))分别为(340±20)mmHg、(351±21)mmHg、(345±23)mmHg、(35±5)mmHg、(38±5)mmHg、(36±6)mmHg,均低于对照组的(356±22)mmHg、(364±23)mmHg、(360±24)mmHg、(40±8)mmHg、(42±8)mmHg、(40±7)mmHg(P<0.05)。结论 气腹压变化情况会对腹腔镜胆囊切除术患者的手术效果造成一定影响,与高气腹压力相比,低气腹压力对其血流动力学、CCE和呼吸循环功能的影响较小。
Objective To investigate the clinical effect of changes in pneumoperitoneum pressure on cardiac circulation efficiency in patients undergoing laparoscopic cholecystectomy.Methods From January 2020 to December 2021,100 patients who underwent laparoscopic cholecystectomy in our hospital were selected for study.They were divided into two groups according to the size of pneumoperitoneum pressure.The patients who used 14 mmHg pneumoperitoneum pressure were included in the control group(n=50),and the patients who used 10 mmHg were included in the observation group(n=50).The operation conditions,hemodynamics,arterial respiratory,and circulatory function indexes at different stages of the operation were compared between the two groups.Results There was no significant difference in operation time,pneumoperitoneum time,and intraoperative blood loss between the two groups(P>0.05).The intestinal exhaust time and feeding time of the observation group were(2.9±0.3)d and(3.5±0.6)d,respectively,which were shorter than those of the control group(4.4±3.0)d and(4.5±2.8)d(P<0.05).The mean arterial pressure(MBP),heart rate(HR),and cardiac circulation efficiency(CCE)in the observation group were(89±9)mmHg,(92±10)mmHg,(89±9)mmHg,(106±11)times/min,(114±11)times/min,(103±9)times/min,(-0.43±0.11),(-0.84±0.73),(0.28±0.12),immediately after pneumoperitoneum establishment(T1),15min after pneumoperitoneum establishment(T2)and 30 min after surgery(T3),respectively.All of them were lower than those of control group(94±10)mmHg,(99±10)mmHg,(95±9)mmHg,(112±12)times/min,(122±12)times/min,(110±11)times/min.(-0.61±0.35),(-0.52±0.25),(0.14±0.27)(P<0.05).The partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))at T1,T2 and T3 were(340±20)mmHg,(351±21)mmHg,(345±23)mmHg,(35±5)mmHg and(38±5)mmHg,(36±6)mmHg,They were lower than (356±22) mmHg, (364±23) mmHg, (360±24) mmHg, (40±8) mmHg, (42±8) mmHg, (40±7) mmHg in the control group, respectively (P<0.05). Conclusion The change in pneumoperitoneu
作者
伍江华
胡海涛
付昕尧
Wu Jianghua;Hu Haitao;Fu Xinyao(Department of Anesthesiology,Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine,Nanchang 310000,China)
出处
《山西医药杂志》
CAS
2024年第4期243-247,共5页
Shanxi Medical Journal
基金
江西省卫生健康委科技计划项目(SKJP220218427)。
关键词
腹腔镜胆囊切除术
气腹压
血流动力学
心脏循环效率
呼吸循环功能
Laparoscopic cholecystectomy
Pneumoperitoneum pressure
Hemodynamics
Cardiac circulation efficiency
Respiratory and circulatory function
