经颅多普勒超声在后腹腔镜手术中的应用  

Application of TCD During Retroperitoneoscopic Operation

作　　者：程玮涛[1] 薛纪秀[1] 华扬[2] 王克杰[1] 魏立民[1] 刘青海[1] 范隆[1] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京市100053 [2]首都医科大学宣武医院超声诊断科,北京市100053

出　　处：《中国超声医学杂志》2006年第11期816-818,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的采用经颅多普勒超声(TCD)观察后腹腔镜手术中患者脑血流动力学的变化。方法选择行后腹腔镜手术患者22例,ASAI^II级,记录气腹前(T0)、气腹后10min(T1)、30min(T2)、60min(T3)、90min(T4)、120min(T5)及停气腹后20min(Te)双侧大脑中动脉(MCA)的平均流速(Vm)、血管搏动指数(PI)、Vm变化百分率(Delt),并同期记录动脉血二氧化碳分压(PaCO2)、平均动脉压(MAP)、心率(HR)。结果与气腹前比较Vm、Delt于T2显著升高,T4达高峰(P<0.01),Te恢复,PI值于T5降至最低(P<0.01),Te恢复。结论后腹腔镜手术中,随着CO2吸收的增加,Vm、Delt各值升高,PI降低,在停止气腹后Vm、Delt降低,PI升高,提示在后腹腔镜手术中的CO2对患者脑血流动力学影响显著。Objective To investigate the changes of cerebral hemodynamics during retroperitoneoscopic operation. Methods Twenty-two patients （ASA grade Ⅰ- Ⅱ） undergoing retioperitoneoscopic operation were selected. The values of mean velocity （Vm）, pulsitility index （PI）, percent changes of Vm （Delt）, PaCO2, MAP and HR were measured before the pneumascos （TO）, during pneumascos 10 min （T1）, 30 min （T2）, 60 min （T3）, 90 min （T4）, 120 min （T5） and 20 min after stopping pneumascos （Te） . Results Compared with before To, the Vm and Delt were increased significantly at T2, reached the maxmum at T4 （P〈0. 01）, came back to normal at Te. PI was decreased to minimum at T5 （P〈0. 01）, up to normal at Te. Conclusions During retroperitoneoscopic operation, along with the increase of CO2 absorption, Vm and Delt were increased but PI were decreased. After stopping pneumascos, Vm and Delt returned to normal, which indicated that there were obvious changes of cerebral hemodynamics during retroperitoneoscopic operation.

关 键 词：后腹腔镜 二氧化碳 经颅多普勒超声 脑血流速度 

分 类 号：R445.1[医药卫生—影像医学与核医学]