不同体位对腹腔镜胆囊手术患者术中气腹及手术时间和血流动力学影响.docVIP

不同体位对腹腔镜胆囊手术患者术中气腹及手术时间和血流动力学的影响 　　摘要：目的： 探究不同体位对腹腔镜胆囊手术患者术中气腹及手术时间和血流动力学的影响。方法： 选取自2012年1月至2015年3月我院收治的60例行腹腔镜胆囊手术治疗的患者为本次研究对象，从术中体位选取角度出发，将其随机分成两组，其中对照组取头高足低体位，实验组取头低足高体位，对比两组术中气腹及手术时间与血流动力学改变情况。结果： ①T1时，两组中心静脉压、收缩压及舒张压均无显著性改变（P0.05）;②T2、T3时点，两组中心静脉压及舒张压、收缩压均较TI时点明显上升，但实验组中心静脉压升高幅度较对照组高（P0.05）;③T4时，两组中心静脉压、收缩压及舒张压无明显变化（P0.05）;④两组手术时间比较差异无显著性（P0.05）。结论： 不同体位对腹腔镜胆囊手术患者术中气腹及血流动力学具有十分重要的影响，临床上应引起足够重视。 　　关键词：体位;腹腔镜胆囊手术;气腹;手术时间;血流动力学;影响 　　Abstract： Objective To explore influence that different position has on pneumoperitoneum， the time of operation and hemodynamics of patients with laparoscopic cholecystectomy. Methods 60 patients who had laparoscopic gallbladder surgery in the hospital from January 2012 to March 2015 were chosen as the object of this research. From the perspective of intraoperative posture selection， they were randomly divided into two groups. Patients in the control group took the high-low position of head and feet while the experimental group took the contrary position. Changes of pneumoperitoneum， the time of operation and the hemodynamics in both two groups were compared. Results ①When it was T1， the central venous pressure， systolic and diastolic blood pressure of two groups of were not significantly changed （P gt; 0.05）. ②When it was T2、T3， central venous pressure and diastolic blood pressure， systolic blood pressure of two groups were significantly increased than TI， but the elevated amplitude of central venous pressure in experiment group was higher than control group （P lt; 0.05） with diastolic blood pressure， systolic blood pressure showing no significant difference （P gt; 0.05）. ③When it was T4， the central venous pressure， systolic and diastolic blood pressure of the two groups showed no significant change （P gt; 0.05）. ④ There was no significant difference in the time of operation in two groups（P0.05）. Conclusion The different position has very important influence on the pneumoperitoneum and hemodynamics in patients with laparosc