特殊体位对妇科腹腔镜手术中呼吸及循环功能的影响

[目的]观察妇科腹腔镜手术中头低臀高位对病人呼吸及循环的影响。[方法]选择妇科择期行腹腔镜手术病人30例,分别在气管插管后气腹前(T0)、气腹后体位改变前(T1)、体位改变15min(T2)、体位改变30min(T3)、术毕气管导管拔出后10min(T4)5个时点记录平均动脉压(MAP)、心电图(ECG)、血氧饱和度(SpO2)、肺顺应性(Comp)、呼吸气道阻力(Raw)、气道峰压(Ppeak)、呼吸末二氧化碳分压(PETCO2)各参数值并进行比较。[结果]T1、T2、T3时较T0时比较Ppeak、Raw、PETCO2、HR、MAP明显升高,Comp降低,T4时较T0时比较PETCO2、HR、MAP升高,差异均有显著意义(P<0.05,P<0.01)。[结论]妇科腹腔镜手术中头低臀高体位可使病人的呼吸、循环系统发生明显的改变。

Influence of special body position on respiratory and circulatory functions of patients during undergoing laparoscope operation

Objective: To observe the influence of head-low feet-high position of patients on their respiratory and circulatory function during gynaecological laparoscopic operation. Methods: A total of 30 cases undergoing selective laparoscopic operation in department of gynecology were selected, and the MAP, HR, SpO2,chest and lung compliance (Comp), airway resistance (Raw), airway peak pressure,and PETCO2 respectively before aeroperitoneum (T0), after aeroperitoneum and before changing body position (T1), 15 minutes (T2) and 30 minutes (T3) after changing body position, ten minutes after extracting tube at the end of operation (T4) were monitored respectively. Results: Compared with T0, the HR,MAP,Ppeak,Raw and PETCO2 of patients elevated significantlyat T1,T2,T3,but Comp of them decreased (P<0.05).Conclusion:Both body position and aeroperitoneumcan change the hemodynamics of patients and decreased the ventilation function of them.