降低后腹腔镜术中气腹压力对老年患者血管内皮细胞的影响研究  

Effect of Pneumoperitoneum Pressure Decrease on Vessel Endothelial of Elderly Patients Undergoing Retroperitoneoscopic Operation

作　　者：孙琳婧[1] 吴瑞青 杨拥军[2] 唐锦荣[1] 缪永辉[1] 仇惠斌 

机构地区：[1]如东县人民医院麻醉科,江苏如东226400 [2]如东县人民医院泌尿外科,江苏如东226400

出　　处：《中外医疗》2017年第26期28-29,32,共3页China & Foreign Medical Treatment

摘　　要：目的评价后腹腔镜手术中降低CO_2气腹压力对老年患者血管内皮细胞的影响。方法方便选取该院2014年10月—2016年6月收治的期行后腹腔镜下泌尿外科手术患者60例,随机均分为A、B两组,A组气腹压力14 mmHg;B组气腹压力11 mmHg。于气腹前(T_0)、气腹后30 min(T_1)、60 min(T_2)、气腹结束后30 min(T_3)记录HR、MAP、CVP、Ppeak,并测定pH值、PaCO_2。并抽取肘静脉血,测定T_0、T_3以及术后24 h(T4)血管性血友病因子(vWF)、血栓调节蛋白(TM)、P选择素(PS)。结果 A组的CVP、Ppeak、PaCO_2及pH值相比与B组在T_1、T_2和T_3分别多出4.82%、16.67%和18.06%。A组vWF、TM、PS和DD在T3均明显升高,分别高出B组22.14%、25.22%、25.30%和92.78%(P<0.05)。结论后腹腔镜术中气腹压力11 mmHg比14 mmHg能有效减小对老年患者血管内皮的损伤。Objective This paper tries toev alu a te effect of red u c in g CO2 pneumo pe ri to neum p re s su re on v a scu la r en d o th e -l ial cells in elderly pat ients undergoing retroper i toneal operat ion. Methods 6 0 p a t ien ts und ergo in g re tro p eri to neosco p ic op-erat ion in urology surgery in this hospi tal from October 2014 to June 2016 were convenient select ion randomly divided into two groups, pneumoperi toneum pressure of 14 mmHg （group A） and 11 mmHg （group B）. The HR, MAP, CVP, Ppeak,pH,Pa- CO2 were re corded af te r intuba t ion and before induc t ion of pneumope rioneum （T0）, and 30min（T1）,60min（T2）aft erpneu- moperioneum, and 30 min af ter deflat ion （T3）. Venous blood samples were o bta in ed a t T0, T 3 an d 2 4h af te r surgery （T4） f o r measurement of vWF, PS, TM. Results T he CVP, Ppeak, PaCO2, an d pH values in group A were 4 .8 2% , 1 6.67%, an d 18.06%, higher than group B in U 2,an d T3 respec tiv e ly . In group A, vWF, TM, PS an d DD in c re a se d a t th e en d of T3, h ig he r th an those in group B, 22.14%, 25.22%, 25.30% and 92.78%（P〈0.05）, higher than that of group B respectively. Conclusion Pneumoperi toneum pressure 11 mmHg is effective in reducing damage on the blood ves sel endothelium than 14 mmHg of elderly pat ients undergoing retropeitoneoscpic.

关 键 词：气腹 泌尿外科手术 血管内皮细胞 深静脉血栓 

分 类 号：R5[医药卫生—内科学]