腹腔镜妇科手术患者的血流动力学在FloTrac/Vigileo系统监测CO_2气腹下不同腹内压下的变化  

Laparoscopic Gynecological Surgery in Patients with Hemodynamic in the Flotrac/Vigileo System Monitor the Change of Internal Pressure under Different CO_2 Pneumoperitoneum

作　　者：徐祝红 王良萍 黄刚 陈广萍 罗家宁 胡慧来 罗燕 

机构地区：[1]广东省东莞仁康医院,广东东莞523952

出　　处：《中国医学创新》2016年第22期55-58,共4页Medical Innovation of China

摘　　要：目的:对接受腹腔镜妇科手术患者的血流动力学在FloTrac/Vigileo系统监测CO_2气腹下不同腹内压下的变化进行研究分析,探讨最适合腹腔镜妇科手术的腹内压。方法:将收集到的120例腹腔镜妇科手术患者分成A、B、C三组,每组各40例,分别在8、12和15 mm Hg腹内压下进行CO_2气腹充气,统计对比三组的手术情况、不同时间点各项血流动力学指标变化以及术中产生的不良症状情况。结果:B、C两组的手术和气腹时间比A组短(P<0.05);A、B、C三组T_1、T_2和T_3时期的HR、SVR、MAP与T0、T4和T5时期相比有显著的上升(P<0.05);B、C两组在T_1、T_2、T_3时期的CO指标与T0、T4和T5时期相比有明显的下降(P<0.05);A组在T_1、T_2、T_3时期和B组在T_2、T_3时期的CVP与各自其他时期的数据对比有明显的上升(P<0.05),而C组在T_1时期的CVP数据与其他时期相比发生了明显的降低(P<0.05);B组产生不良症状的患者比例最低,C组最高(P<0.05)。结论:FloTrac/Vigileo系统监测CO_2气腹下腹内压12 mmHg能够明显缩短患者的手术和气腹时间,对于腹腔镜妇科手术患者的血流动力学影响最小,且术中产生不良症状的患者比例最低,是理想的CO_2气腹压。Objective： To explore the most suitable of laparoscopic surgery for gynecological intra- abdominal pressure on hemodynamics of patients undergoing gynecological laparoscopic surgery in FloTrac/Vigileo system monitoring CO2 pneumoperitoneum under different intra-abdominal pressure change to carry on the research analysis.Method： The collected 120 patients undergoing gynecological laparoscopic surgery were divided into three groups, A, B, and C group, 40 cases in each group.They were respectively given 8, 12 and 15 mm Hg intra- abdominal pressure of CO2 pneumoperitoneum inflatable.The operation, in different time points the hemodynamic changes and operation of adverse symptoms of three groups were compared.Result： The time of surgery and pneumoperitoneum in B and C group were shorter than the A group （ P〈0.05 ） .The HR, SVR and MAP of three groups in T1, T2 and T3 period were more increased than To, T4 and T5 （ P〈0.05 ） .The CO of B and C group in T1, T2 and T3 period significantly decreased compared with other period （ P〈0.05 ） .The CVP of A group in T1, T2 and T3 period and B group in T2 and T3 period compared with each other period, the data obviously increased （ P〈0.05 ）,C group in the T1 significantly reduced compared with other period （ P〈0.05 ） .The adverse symptoms of Bgroup was lowest proportion, C group was the highest （P〈0.05） .Conclusion： FloTrac/Vigileo system monitoring CO2 pneumoperitoneum abdominal 12 mm Hg pressure can significantly shorten the patient＇s surgery and the time of pneumoperitoneum, for gynecological laparoscopic surgery in patients with hemodynamic effects is the smallest, and intraoperative produce adverse symptoms.The proportion of patients with minimum, which is the ideal of CO2 pneumoperitoneum intra-abdominal pressure.

关 键 词：腹腔镜手术 血流动力学 FloTrac/Vigileo系统 CO2气腹 

分 类 号：R713[医药卫生—妇产科学]