晶体液与胶体液对妇科患者腹腔镜手术时血流动力学影响的对比

Effects of fluid therapy on hemodynamics in gynecological patients undergoing laparoscopic

目的:探讨液体治疗对妇科患者腹腔镜手术时血流动力学的影响。方法:选取2013年1月至2015年1月的95例妇科腹腔镜手术患者作为研究对象,按照随机数字表法分为对照组48例和观察组47例,其中对照组患者在麻醉前行晶体液体治疗,观察组患者麻醉前行胶体液体治疗,分析两组患者手术时血流动力学的变化。结果:观察组患者各个时间点的平均动脉压(mean artery pressure,MAP)比较,差异无统计学意义(P>0.05),观察组患者各个时间点的心率(heart rate,HR)比较,差异无统计学意义(P>0.05);但对照组患者各个时间点的MAP及HR波动程度较明显,且在T2时HR值高于T_1(t=8.1008,P<0.05),T_2时MAP值高于T_1(t=9.6814,P<0.05)。观察组及对照组患者各个时间点的心输出量(cardiac output,CO)比较,差异均无统计学意义(P>0.05)。观察组患者各个时间点的每搏输出量(stroke volume,SV)比较,差异均无统计学意义(P>0.05);而对照组SV在T_4时间点低于T_3(t=5.4483,P<0.05)。结论:麻醉前液体治疗可有效减少妇科患者腹腔镜手术对血流动力学的影响,且胶体液体治疗效果更优于晶体液体治疗,值得推广。

Objective：To investigate the effect of fluid therapy on hemodynamics in gynecological patients undergoing laparoscopic surgery. Methods ：95 cases of gynecological laparoscopic surgery from January 2013 to January 2015 in our hospital were randomly divided into two groups. 48 cases in the control group were treated with liquid crystal before anesthesia, while 47cases in the observation group with colloid liquid before an- esthesia, and then the hemodynamics of the patients in both groups were analyzed. Results： It was of no statistical significance in MAP comparison and HR comparison, but the MAP and HR fluctuation the control group were obvious at different time, and MAP and HR values at T2 were higher than those at T1. It was of no statistical significance in CO and SV, but in the control group, SV at T4 was higher than that at T3. Conclusion ： Flu- id therapy before anesthesia can effectively reduce the impact of laparoscopic surgery on hemodynamics in gynecological patients, and colloid liquid treatment is better than the liquid crystal therapy, thus, it is worth popularization.