腹腔镜妇科手术患者的血流动力学在FloTracVigileo系统监测CO2气腹下不同腹内压下的变化[权威资料].docVIP

腹腔镜妇科手术患者的血流动力学在FloTrac/Vigileo系统监测CO2气腹下不同腹内压下的变化 　　【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CO2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CO2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（P0.05）；A、B、C三组T1、T2和T3时期的HR、SVR、MAP与T0、T4和T5时期相比有显著的上升（P0.05）；B、C两组在T1、T2、T3时期的CO指标与T0、T4和T5时期相比有明显的下降（P0.05）；A组在T1、T2、T3时期和B组在T2、T3时期的CVP与各自其他时期的数据对比有明显的上升（P0.05），而C组在T1时期的CVP数据与其他时期相比发生了明显的降低（P0.05）；B组产生不良症状的患者比例最低，C组最高（P0.05）。结论：FloTrac/Vigileo系统监测CO2气腹下腹内压12 mm Hg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CO2气腹压。 　　【关键词】 腹腔镜手术； 血流动力学； FloTrac/Vigileo系统； CO2气腹 　　Laparoscopic Gynecological Surgery in Patients with Hemodynamic in the Flotrac/Vigileo System Monitor the Change of Internal Pressure under Different CO2 Pneumoperitoneum/XU Zhu-hong，WANG Liang-ping，HUANG Gang，et al.//Medical Innovation of China，2016，13（22）：055-058 　　【Abstract】 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（P0.05）.The HR， SVR and MAP of three groups in T1， T2 and T3 period were more increased than T0， T4 and T5（P0.05）.The CO of B and C group in T1， T2 and T3 period significantly decreased compared with other period（P0.05）.The CVP of A group in T1，