琥珀酰明胶对腹腔镜手术患者内脏灌注的影响及术后护理  

Effect of Succinylated Gelatin Injection on Visceral Perfusion in Patients with Laparoscopic Operation and Investigation on Its Postoperative Nursing

作　　者：马立军[1] 

机构地区：[1]大庆油田总医院心导管室,黑龙江大庆163001

出　　处：《中国药业》2015年第11期115-117,共3页China Pharmaceuticals

摘　　要：目的探讨琥珀酰明胶注射液对腹腔镜手术患者内脏灌注的影响并总结术后患者的护理要点。方法选择拟行腹腔镜手术患者60例,随机分为对照组和观察组,各30例。两组患者于全身麻醉诱导开始后30 min内分别输注乳酸钠林格液和琥珀酰明胶12 mL/kg。在诱导前即刻（T0）,输注结束时（T1）,气腹后5 min（T2）、15 min（T3）、30 min（T4）,结束气腹后5 min（T5）、15 min（T6）、30 min（T7）时监测并记录血流动力学指标和胃黏膜张力计测定值。同时采取有针对性的护理措施。结果两组患者T1-T7中心静脉压均较T0明显升高（P〈0.05）。观察组外周血管阻力指数（SVRI）各时点指标均明显低于对照组（P〈0.05）。观察组患者心室收缩加速指数（ACI）及心脏指数（CI）较对照组明显上升（P〈0.05）。两组患者胃黏膜pHi从T4起明显降低（P〈0.05）,而各时点组间差异不显著（P〉0.05）。两组患者T1-T2的胃黏膜-血二氧化碳分压均较T0有显著下降（P〈0.05）,而自T3起,对照组该指标则明显上升（P〈0.05）,而观察组与T0水平相当（P〉0.05）。结论琥珀酰明胶注射液能显著改善腹腔镜手术患者的器官灌注,同时也能较好地维持患者手术过程中血流动力学的稳定。Objective To investigate the influence of Succinylated Gelatin Injection on visceral perfusion in the patients with laparoscopic operation and to evaluate the key points of its postoperative nursing. Methods 60 patients undergoing laparoscopic operation were randomly divided into the control group and the observation group, 30 cases in each group. Both the two groups were infused by sodium lactate Ringer＇s solution and Succinylated Gelatin Injection 12 mL/kg within 30 min after beginning of anesthetic induction respectively. The hemodynamic indexes and the detecting values of gastric mucosal tensiometer were monitored and recorded immediately before induction （T0）, at the end of infusion （T1）, at 5 min（T2）, 15 min （T3） and 30 min （T4） after pneumoperitoneum, at the end of 5 min （T5）, 15min （T6） and 30min （T7） after the end of pneumoperitoneum. At the same time the targeted nursing measures were adopted. Results CVP at T1- T7 in the two groups were significantly elevated than that at T0（ P 〈 0. 05）. SVRI at various time points in the observation group were significantly lower than that in the control group（ P 〈 0. 05）. ACI and CI in the observation group were significantly increased compared with the control group（ P 〈 0. 05）. pHi in the two group began to be obviously decreased from T4（ P 〈 0. 05）, but which at various time points had no statistical differences between the two groups（ P 〉 0. 05）. Pg-aCO2 at T1- T2 in the two groups were significantly decreased compared with that at To, but this index in the control group began to be significantly ascended from T3（ P 〈 0. 05）, but which in the observation group was similar to the level at To, no statistically significant difference was found （P 〉 0. 05）. Conclusion Succinylated Gelatin Injection can significantly improve the organ perfusion in the patients with laparoscopic operation, at the same time can better maintain the patient＇s hemodynamic stability during operation.

关 键 词：琥珀酰明胶注射液 腹腔镜 内脏灌注 护理 

分 类 号：R969.4[医药卫生—药理学] R982[医药卫生—药学]