无气腹腹腔镜对中老年全子宫切除患者血流动力学、胃肠功能及脑供氧水平的影响  

Effects of gasless laparoscopy on hemodynamics,gastrointestinal function and cerebral oxygen supply of middle-aged and elderly patients undergoing total hysterectomy

作　　者：王春玲 蔡美燕 邓文 田韵 WANG Chun-ling;CAI Mei-yan;DENG Wen(不详;Department of Gynaecology,Women,Children and Reproduction Center,The 924th Hospital of People’s Liberation Army Joint Service Support Force,Guilin 541002,China)

机构地区：[1]联勤保障部队第九二四医院妇幼与生殖中心妇科,广西桂林541002

出　　处：《中国医学装备》2022年第9期106-110,共5页China Medical Equipment

基　　金：广西壮族自治区卫生健康委员会(Z20201385)“多点悬吊式免气腹腹腔镜应用与宫内孕合并宫外孕的治疗”。

摘　　要：目的:分析无气腹腹腔镜对中老年全子宫切除患者血流动力学、胃肠功能及脑供氧水平的影响。方法:选取在医院进行手术治疗的100例中老年全子宫切除患者,根据治疗方法的不同将其分为观察组和对照组,每组50例。观察组给予无气腹腹腔镜手术,对照组给予二氧化碳气腹腹腔镜手术。比较两组患者手术各项指标、血流动力学指标、胃肠功能指标、脑供氧水平及术后不良反应发生情况。结果:观察组术中手术时间、住院天数及住院费用明显少于对照组,差异有统计学意义(t=5.263,t=4.552,t=8.052;P<0.01)。观察组患者平均动脉压、心率低于对照组,差异有统计学意义(t=4.006,t=11.650;P<0.05),舒张末期与收缩末期血流速高于对照组,差异有统计学意义(t=11.888,t=6.664;P<0.05)。观察组与对照组比较,患者肠道排气时间、肠鸣音恢复时间及首次进食时间均明显缩短,差异有统计学意义(t=6.532,t=6.060,t=37.852;P<0.05)。观察组患者术后动脉血二氧化碳分压、动脉血氧饱和度及碱剩余值均高于对照组,差异有统计学意义(t=7.925,t=5.834,t=28.972;P<0.05)。观察组术后不良反应发生率低于对照组,差异有统计学意义(x^(2)=4.336,P<0.05)。结论:在中老年全子宫切除术中,无气腹腹腔镜能够维持良好的脑氧供需平衡,减少对患者血流动力学的影响,缩短手术时间、住院天数,降低住院费用,促进患者术后胃肠功能的恢复,减少术后并发症的风险,具有良好的临床应用价值。Objective:To analyze the influence of gasless laparoscopy on hemodynamics,gastrointestinal function and cerebral oxygen supply in middle-aged and elderly patients who underwent total hysterectomy.Methods:100 middleaged and elderly patients who underwent the operative treatment of total hysterectomy in hospital were selected,and they were divided into observation group and control group according to different therapeutic method,with 50cases in each group.The observation group received gasless laparoscopy,and control group received carbon dioxide pneumoperitoneum laparoscopic surgery.The occurrences of various indicators of surgery,hemodynamic indicator,the indicators of gastrointestinal function,the level of cerebral oxygen supply and postoperative adverse reaction between two groups were compared.Results:The operational time during surgery,length of stay and hospitalization expenses of observation group were significantly less than those of control group(t=5.263,t=4.552,t=8.052,P<0.05),respectively.The mean arterial pressure and heart rate of observation group were significantly lower than those of control group(t=4.006,t=11.650,P<0.05),and blood flow velocities at end diastole and end systole of observation group were significantly higher than those of control group(t=11.888,t=6.664,P<0.05),respectively.Compared with those of control group,the intestinal exhaust time,the recovery time of bowel sounds and the time of first eating of observation group were significantly shortened(t=6.532,t=6.060,t=37.852,P<0.05),respectively.The partial pressure of carbon dioxide,arterial oxygen saturation and the value of base excess after surgery of observation group were significantly higher than those of control group(t=7.925,t=5.834,t=28.972,P<0.05),respectively.The incidence of postoperative adverse reactions of observation group was significantly lower than that of control group(x2=4.336,P<0.05).Conclusion:When middle-aged and elderly patients undergo total hysterectomy,gasless laparoscopy can maintain favorable balance of

关 键 词：无气腹腹腔镜 中老年全子宫切除 血流动力学 胃肠功能 脑供氧水平 

分 类 号：R713.4[医药卫生—妇产科学]