摘要
目的：观察不同CO2气腹压力对妇科腹腔镜手术患者应激状态的影响。方法：选取9．015年2～10月于我院行腹腔镜手术的妇科手术患者90例，依据CO2气腹压力不同分为A、B、C3组，记录3组患者手术过程中心率（HR）、血压、呼吸末CO2分压（PetCO2）变化，并对术前（T0）、术中30min（T2）、术后12h（T，）应激指标变化进行比较。结果：3组术前HR、血压、PetCO2水平比较无统计学差异（P〉0．05），气腹30min后HR、血压、PetCO2水平均较术前明显上升（P〈0．05）；C组患者气腹30min后HR、血压、PetCO2水平均明显高于A、B组（P〈0．05）；A、B组间气腹30min后HR、收缩压（SBP）、舒张压（DBP）水平比较无统计学差异（P〉0．05）；B组气腹30min后PetCO2水平明显高于A组（P〈0．05）；T1时3组患者血清皮质醇（COR）、去甲肾上腺素（NE）及前列腺素E2（PGE2）水平明显升高（P〈0．05）；C组患者血清COR、NE、PGE2水平显高于A、B组（P〈0．05）；T2时3组血清COR、NE、PGE2水平继续上升，但组间比较与术中相同。结论：低气腹压力对妇科腹腔镜手术患者应激状态影响较小，不影响手术操作，且能获得良好肌松及视野，可优先选用。
Objective： To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy. Methods： A total of 90 patients who were admitted in our hospital from February 2015 to October 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to differ- ent CO2 pneumoperitoneum pressure. The changes of HR, BP, and peak end tidal CO2 （PetCO2） during the operation process in the three groups were recorded. The changes of stress indicators before operation （TO）, 30 min during operation （T1）, and 12 h after operation （T2） were compared. Results： The comparison of HR, BP, and PetCOa levels before operation among the three groups was not statistically significant （P〉0.05）. HR, BP, and PetCO2 levels 30 rain after pneumoperitoneum were sig- nificantly elevated when compared with before operation （P〈0.05）. HR, BP, and PetCO2 levels 30 min after pneumoperitone- urn in group C were significantly higher than those in groups A and B （P〈0.05）. The comparison of HR, systolic blood pres- sure （SBP）, and diastolic blood pressure （DBP） 30 min after pneumoperitoneum between group A and B was not statistically significant （P〉0.05）. PetCO2 level 30 rain after pneumoperitoneum in group B was significantly higher than that in group A （P〈0.05）. The serum COR, norepinephrine （NE）, and phenyl glycidyl ether 2 （PGE2） levels in the three groups at T1 weresignificantly elevated （P〈0.05）. The serum COR, NE, and PGE2 levels in group C were significantly higher than those in groups A and B （P〈0.05）. The serum COR, NE, and PGE2 levels in the three groups at T2 were gradually elevated, but the comparison among the groups was not statistically significant （P〈0.05）. Conclusions： Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.
出处
《海南医学院学报》
CAS
2016年第19期2312-2314,共3页
Journal of Hainan Medical University
基金
张家口市科技进步项目(20122978)~~
关键词
气腹压力
腹腔镜手术
妇科
应激状态
Pneumoperitoneum pressure
Laparoscopy
Gynecology
Stress state
