截石位改变速度在妇科腹腔镜手术患者中的应用

Application of change speed of lithotomy position in the patients with gynecological laparoscopic surgery

目的探讨截石位改变速度在妇科腹腔镜手术患者中的应用。方法将收治的120例妇科腹腔镜手术患者随机分为观察组和对照组各60例,2组气腹压力均为11 mm Hg,对照组截石位改变速度6 s内,观察组>30 s,比较2组的血流动力学及血气指标的变化。结果 2组患者气腹后的SBP、DBP均较气腹前增加(P<0.05);观察组在气腹后的SBP、DBP增加幅度小于对照组(P<0.05);观察组的呼气末二氧化碳分压(PETCO2)在气腹后与气腹前无统计学意义(P>0.05);对照组在气腹后的PETCO2高于气腹前,差异有统计学意义(P<0.05)。观察组与对照组的气道压力在气腹后均有上升趋势,两组之间无统计学意义(P>0.05)。结论延长截石位时体位改变的时间,可减少体位改变给妇科腹腔镜手术患者带来的血流动力学影响,更有利于肺功能恢复。

Objective To explore the application of change speed of lithotomy position in the patients with gynecological laparoscopic surgery. Methods A total of 120 gynecological laparoscopic surgery patients in our hospital were randomly divided into observation group and control group,pneumoperitoneum pressure of two groups was 11 mm Hg. The change speed of lithotomy position in the control group was in 6 s,the observation group was 〉30 s,and the changes of hemodynamics and blood gas indexes were compared. Results SBP and DBP after pneumoperitoneum in the two groups were increased compared with that before pneumoperitoneum（ P〈 0. 05）. The increase of DBP and SBP after pneumoperitoneum in the observation group was less than that in the control group（ P〈 0. 05）. PETCO2 after pneumoperitoneum in the observation group showed no statistically significant compared with pneumoperitoneum before（ P〉 0. 05）,but the control group had higher PETCO2 than that before pneumoperitoneum,there were statistically significant differences（ P〈 0. 05）. The observation group and the control group had a tendency to rise in airway pressure after pneumoperitoneum,but no statistical significance between the two groups was found（ P〉 0. 05）. Conclusion Prolonging change time of lithotomy position can reduce the influence of hemodynamics for the patients with gynecological laparoscopic operation,and it is beneficial to the recovery of lung function.