摘要
目的腹腔镜手术日益盛行,但是妇科腔镜手术CO2气腹和头低脚高的特殊体位会对患者的循环产生影响。其中,头低脚高位时患者下肢的血液回流增加,可能导致每搏量、心排血量、心脏指数和动脉压增加,左右脑的局部脑氧饱和度降低;CO2气腹造成了患者腹内压增高,周围静脉阻力上升,腹主动脉受压,形成体循环阻力增加等生理变化,会对患者循环造成不良影响,尤其是老年人和心脏病患者影响更大。低腹压或零腹压腹腔镜和通过血管活性药物减少气腹对循环的影响作用不明显,而且应用范围还需进一步探讨和研究。本文就妇科腔镜手术CO2气腹和头低脚高的特殊体位对患者循环产生的影响及减少这种影响的方法做一综述。
Laparoscopic operations are increasingly popular. But CO2 pneumoperitoneum, Trendelenburg position can influence on stabilization of cardiovascular hemodynamics. Trendelenburg position can increase inferior extremital recirculation, raise stroke volume, cardial output, cardial index and arterial pressure, lower the rSO2 （regional cerebral oxygen saturation）. CO2 pneumoperitoneum can rise up intraabdominal pressure and SVR （systemic vascular resistance） and influence on stabilization of cardiovascular hemodynamics, especially the elderly and cardiopath patients. No or low pressure pneumoperitoneum and vasoactive agent can illegibility lower the impact of pneumoperitoneum on stabilization of cardiovascular hemodynamics. This article reviews the influence of Trendelenburg position and CO2 pneumoperitoneum on hemodynamics and how to reduce it.
出处
《中国当代医药》
2012年第32期17-18,共2页
China Modern Medicine
关键词
腹腔镜
头低脚高位
CO2气腹
血流动力学
Laparoscopy
Trendelenburg position
CO2 pneumoperitoneum
Hemodynamics
