老年人腹腔镜手术安全性评价  

The Evaluation on the Safety of Laparocopy in Elderly Patients

作　　者：崔宏力[1] 刘建东[1] 杨桂梅[2] 曾艳芳[2] 

机构地区：[1]北京市垂杨柳医院普通外科,北京100022 [2]承德医学院附属医院老年病科,河北承德067000

出　　处：《河北医学》2008年第11期1359-1361,共3页Hebei Medicine

摘　　要：目的：研究老年腹腔镜手术围手术期生理功能的变化，以期探讨老年腹腔镜手术的安全性及可行性。方法：回顾分析我院2006年1月至2008年4月期间收治的老年腹腔镜手术病例64例，年龄65～96岁，观察术前、术中、术后的血气分析、血液动力学、肝肾功能的变化。结果：与术前、术后相比，术中的pH值显著下降（P〈0．05）；而术中PO2、PCO2明显高于术前、术后水平（P〈0．05）；术前、术中及术后平均动脉压、心率变化无显著性差异；但术中末梢血氧饱和度明显高于术前、术后水平（P〈0．05）。对术前、术后血电解质、肝肾功能变化的分析发现：除术后血尿素氮显著低于术前水平外（P〈0．05），其他指标间并无显著性差异（P〉0．05）。结论：老年人行腹腔镜手术时CO2气腹对机体有一定影响，但在密切监护下完成手术，仍然是安全可行的。Objective： To explore the safety and feasibility in laparoeopy for elderly patients. We studied the changes of physiological changes＇of them. Method： We reviewed datas of 64 cases with laparoscopic surgery , who were 65-96 years old, from Jan. 2006 to Apr. 2008. In the mean while , We observed the blood gas analysis, hemodynamics and the function of liver and renal during, before and after operation. Result： The value of pH during operation was decreased （ P 〈 0.05 ） compared with before and after operation. While , the value of PO2 ,PCO2 was increased than those in before and after operation （ P 〈 0.05 ）. There no significant difference in mean arterial pressure and heart rate during, before and after operation. But the value of blood oxygen saturation during operation was more than those in in before and after operation （ P 〈 0.05 ）. There＇s no significant difference in other indexs except the value of blood urea nitrogen was lower than that before operation （ P 〈 0.05 ）. Conclusion： It＇s feasible for the aged to operate with laparocopy , If we monitor carefully,there＇s influence of CO2 pneumoperitoneum.

关 键 词：老年人 腹腔镜 安全性 

分 类 号：R656[医药卫生—外科学]