临床医学论文-正反特伦德伦伯格卧位对呼吸循环功能影响.doc

临床医学论文-正反特伦德伦伯格卧位对呼吸循环功能影响【摘要】目的观察腹腔镜手术期间正反特伦德伦伯格(Trendelenburg)卧位对患者呼吸循环功能的影响。方法女性腹腔镜胆囊切除术患者30例:A组:术中取反向特伦德伦伯格卧位;女性卵巢囊肿切除术患者30例:B组:术中取特伦德伦伯格卧位,监测气腹前、气腹后、体位改变前、体位改变后15、30min、术毕气管导管拔除后10min时的MAP、HR、SpO2、p:、气道阻力:Raw:、气道峰压:Ppeak:、PETCO2。结果气腹及体位改变后两组患者MAP、HR、SpO2、Paw、Ppeak、p降低,组内分别与气腹前相比,差异均有统计学意义:P<);组间比较气腹后A组Paw、Ppeak、p低于B组,差异均有统计学意义:P<),拔管后B组HR、MAP明显高于A组。结论气腹与体位均使患者循环动力学发生改变,通气功能下降,其中以特伦德伦伯格卧位下降更为明显。【关键词】腹腔镜手术特伦德伦伯格卧位围术期呼吸功能循环功能ObservationonInfluenceofSteepTrendelenburgPositiononRespiratoryandCirculatoryFunctionin60Patients)Abstract:ObjectiveToobservetheinfluenceofsteepTrendelenburg',holecystectomyundertheconditionofreverseTrendelenburg',whowereperformedresectionofovariancystundertheconditionofsteepTrendelenburg',suchasmeanairwaypressure(MAP),heartrate(HR),SpO2,p),resistanceofairway(RAW),peaktidalCO2pressure(PETCO2),werepressureofairway(Ppeak)andendmonitoredbeforeandafterpneumoperitoneum,,HR,SpO2,RAW,PpeakandPETCO2afterpneumoperitoneumandpositionchange,pwasdecreased,parisonwasdone(P<).RAW,PpeakandPETCO2afterpneumoperitoneumweresignificantlyhigher,pwaslowerinGroupAthanin