改良中凹卧位在妇科腹腔镜手术的应用  

The clinical applicationof amended concave position in gynecological laparoscopy surgery

作　　者：吴浩[1] 张伟[1] 蒋忠[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《中国医学装备》2016年第3期91-94,共4页China Medical Equipment

摘　　要：目的：观察改良中凹卧位对妇科腹腔镜术中患者气道峰压（Ppeak）、呼气末二氧化碳分压（PETCO_2）的影响及术后复苏的影响。方法：对45例经美国麻醉师协会（ASA）评分为Ⅰ~Ⅱ级的患者择期行妇科腹腔镜手术,随机将其分为对照组（23例）和观察组（22例）。对照组采用头低脚高截石位（T体位）;观察组采用改良中凹卧位,观察两组患者术中Ppeak及PETCO2变化情况,统计两组患者术后的拔管时间,恶心、呕吐及寒战等不良反应的发生率。结果：术中气腹后15min、30 min、60 min对照组患者的Ppeak高于观察组,差异有统计学意义（t=2.526,t=2.838,t=2.881;P〈0.05）;对照组患者气腹后30 min、60 min的PETCO_2高于观察组,差异有统计学意义（t=2.515,t=2.436;P〈0.05）,术后拔管时间对照组大于观察组,差异有统计学意义（t=2.063,P〈0.05）。结论：改良中凹卧位可以降低妇科腹腔镜术中患者的Ppeak和PETCO2,有利于患者术后的复苏。Objective： To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery. Methods： Eighty ASA Ⅰ-Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery. Results： The Ppeak and PETCO2 of group A were higher than that of group B（t=2.526, t=2.838, t=2.881; P〈0.05）. The time of extubation of group A were higher than that of group B after surgery（t=2.515, t=2.436; P〈0.05）. Conclusion： Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

关 键 词：气道峰压 呼末二氧化碳分压 术中体位 腹腔镜 妇科手术 

分 类 号：R614[医药卫生—麻醉学]