全麻下腹腔镜胆囊切除术对血流动力学的影响
HEMODYNAMIC CHANGES LAPAROSCOPE CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA
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摘要: 目的 :观察 30例全麻下腹腔镜胆囊切除术患者 ,头高脚低位 (rT)和CO2 气腹对循环功能的影响。方法 :用无创血流心排监护仪 (TECO2 )及Datex监护仪 ,监测rT位气腹及术毕各时点的血流动力学指标。结果 :rT位后SV、CO、CI均明显下降 ,气腹后除SV无明显变化外 ,其余各参数均明显增加 (P 0 0 5 ,P 0 0 1)。结论 :腹腔镜胆囊切除虽属微创手术 ,对机体干扰小 ,但对老年人、心功能欠佳者仍需注意加强监测治疗 ,以提高麻醉安全性Abstract: Objective:To observe the hemody namic influence by rT and co 2 on Laparoscopic Cholecystectomy under general anesthesia,30 cases were studied.Methods:Hemodynamic parameters(HR、SV、CO、CI、SpO 2)were measured with monitor Datex and TECO 2 during the operating.The data were recorded after the patients being placed to rT position,CO 2 being insufflated into peritoneal cavity and the operation being done.Results:MAP、HR、SV、CO、CI were significantly reduced after rT position.Then,those were significantly increased after CO 2 peritoneal insufflation,but SV had no significant change.These changes would be disadvantageous to the old or heart disease patients.Conclusion:Monitor treatment should be paid to the patients,though Laparoscope Cholecystectomy has minor tramun and disturbence to the patient.