腔镜甲状腺手术二氧化碳对颅内压的影响

The effect of carbon dioxide insufflation on intracranial pressure during endoscopic thyroidectomy

目的:探讨腔镜下胸乳入路甲状腺手术充入二氧化碳(CO_2)对颈内静脉压力及颅内压的影响。方法:选择40例经胸乳入路行腔镜甲状腺手术的患者,分别于术中充入CO_2前(T_1),充气后10 min(T_2)、20 min(T_3)、40 min(T_4),关闭充气后5 min(T_5)、20 min(T_6),测量颈内静脉压力、颈静脉球部压力,并比较不同时间点颈内静脉压力、颈静脉球部压力的变化。结果:与T_1相比,颈内静脉压力、颈静脉球部压力在术中充气后各时点均有显著上升(P<0.05);T_5、T_6时,颈内静脉压力、颈静脉球部压力均逐渐降低,与T1相比差异均无统计学意义(P>0.05)。结论:腔镜下胸乳入路甲状腺手术中充入CO_2可导致颈内静脉压力、颅内压显著升高。

Objective：To explore the effects of carbon dioxide insufflation on internal jugular vein pressure and intracranial pressure during endoscopic thyroidectomy via a breast approach. Methods： The clinical data of 40 patients who underwent endoscopic thyroidectomy via a breast approach were analyzed. The internal jugular vein pressure and internal jugular bulb pressure before carbon dioxide insufflation （T1 ） ,10 min （T2） ,20 rain （T3） ,40 min （T4） after insufflation and 5 min （T5） ,20 min （T6） after exsuffiation were measured and the pressure changes at different time points were compared. Results：The internal jugular vein pressure and internal jugular bulb pressure after carbon dioxide insufflation （ T2-T4 ） were significantly increased than T1 （ P 〈 0.05 ）. There was no signifi- cant difference between T5-6 and T1 （ P 〉 0.05 ）. Conclusions ： The internal jugular vein pressure and intraeranial pressure significantly increase after carbon dioxide insufflation during endoscopic thyroidectomy via a breast approach.