妇科腹腔镜气腹对血流动力学影响

Effect of CO_2-pneumoperitoneum on Hemodynamic Parameters During Gynecologic Laparoscopy

目的本文通过经食道超声多普勒对降主动脉血流动力学的监测,探讨妇科腹腔镜手术中CO2气腹对患者血流动力学的影响。方法选择40例择期全身麻醉下行“腹腔镜检”的女性患者为研究对象。麻醉诱导后摆截石位,以食道超声监测患者充气腹和放气腹前后的心率(HR)、平均动脉压(MAP)、每搏量(SV)、心输出量(CO)、总外周阻力(TSVR)的变化。结果充气腹前后HR、MAP、TSVR升高(P<0.05),SV和CO下降但差异无显著性(P>0.05),放气腹前后的HR、MAP、TSVR、SV及CO的变化差异无显著性(P>0.05)。结论妇科腹腔镜手术时腹腔压力对血流动力学影响小。

Objective To evaluate the influences of 002 pneumoperitoneoum on hemedynamic parameter variations during gynecologic laparoscopic procedures through the transesophageal echo-doppler （TED） monitoring. Methods Forty female patients scheduled for laparoscopy procedure undergoing general anesthesia were selected in this study. The HR, MAP, SV, CO, TSVR were monitored by a TED hemodynamic monitor （Hemosonic TM 100,Arrow）, Results After inflation, the heart rate （HR）, mean arterial pressure （MAP）, and total systemic vascular resistance （TSVR） increased significantly（P〈0.05）, but stroke volume （SV） and cardiac output （（30） remained stable （P〉0.05）. After deflation the hemedynarnic parameters did not alter significantly as compared with before deflation （P〉0.05）. Conclusions Our data suggest that intraabdominal pressure （IAP） 12mmHg peritoneal inflation exerts little influence on hemodynamic parameters during the gynecologic laparoscopic procedure.