二氧化碳气腹对下肢静脉血流动力学的影响

Effect of Carbon dioxide pneumoperitoneum on the lower extremity venous hemodynamic

目的研究二氧化碳气腹及体位对下肢静脉血流动力学的影响。方法选择需行胆囊切除术患者60例,其中行腹腔镜胆囊切除术(LC)30例,行开腹胆囊切除术(OC)30例,测定气腹前后及体位改变后下肢静脉压力变化。结果腹腔镜手术中,下肢静脉压力显著升高,取头高脚低位后,下肢静脉压力进一步增高,而OC则对下肢静脉压力无显著性影响。气腹后及术后5分钟,腹腔镜手术同开腹手术相比较,差异有显著性意义。结论二氧化碳气腹及体位改变(头高脚低位)引起了下肢静脉压力的增高,加重了下肢静脉血流淤滞,增加了血栓形成的风险。

Objective To investigate the effect of Carbon dioxide pneumoperitoneum on the lower extremity venous hemodynamic.Methods 60 patients underwent cholecystectomy,30 cases underwent laparoscopic cholecystectomy（LC） and 30 open cholecystectomy（OC） were rnrolled in the study.The lower extremity venous pressure before and after pneumoperitoneum were observed.Results Lower extremity venous pressure was greatly increased during LC operation and it increased further when we took reverse trendelenburg position.But in the case of OC operation,the changes of lower extremity venous pressure was not significant.Moreover,after pneumoperitoneum and 5 minutes after operation,the changes in LC,compared with OC,were statistically significant.Conclusion Carbon dioxide pneumoperitoneum and the reverse trendelenburg position caused the increase of the lower extremity venous pressure and aggravated the blood stagnation.Our investigation indicates that there is a higher temporary risk of thrombosis under Carbon dioxide pneumoperitoneum.