妇科腹腔镜手术二氧化碳气腹合并体位改变对心脏电生理稳定性的影响

发布时间：2018-03-02 11:26

本文选题：腹腔镜　切入点：二氧化碳气腹　出处：《实用医学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的:观察妇科腹腔镜手术CO2气腹合并体位改变对心脏电生理的影响。方法:选择择期行妇科腹腔镜手术的患者30例,全身麻醉,气腹压12 mm Hg,头低位15°。记录并分析麻醉前(T0)、麻醉后(T1)、气腹后1 min(T2)、气腹头低位后30 min(T3)、放气平卧位后30 min(T4)时的基本监测指标和QT间期(QT)、T波峰末间期(Tp-e),心率校正QT间期(QTc),QT离散度(QTd),Tp-e/QT的变化。结果:与T0时刻相比,T1时刻QTd明显延长(P0.05),T2、T3、T4时刻QT、QTc、QTd、Tp-e、Tp-e/QT明显延长(P0.05);与T2时刻相比,T3时刻QTc、QTd、Tp-e、Tp-e/QT明显延长(P0.05)。结论:妇科腹腔镜手术中CO2气腹合并头低脚高位会延长心室复极时程,破坏心脏电生理稳定性,可能增加心血管事件发生率。
[Abstract]:Objective: to observe the effect of CO2 pneumoperitoneum combined with posture change on cardiac electrophysiology in gynecological laparoscopic surgery. Pneumoperitoneum pressure was 12 mm Hg, head-low position was 15 掳. The basic monitoring indexes were recorded and analyzed before and after anesthesia, after anesthesia, after anesthesia, 1 min after pneumoperitoneum, 30 min after pneumoperitoneum, 30 min after pneumoperitoneum and 30 min after supine position. Results: compared with T 0, QTd at T 1 time significantly prolonged QT T 2 T 3 T 3 T 4 QT T c T p T p E P P 0.05. Conclusion: CO2 pneumoperitoneum head low foot height during gynecological laparoscopy was significantly longer than that at T 2 time (P 0 05), and T 3 T T T P P P 0 05. Conclusion: CO2 pneumoperitoneum in gynecological laparoscopic surgery with low head and low foot height was significantly longer than that at T 2 time (P 0 05). The results showed that: during gynecologic laparoscopy, the CO2 pneumoperitoneum combined with lower head and lower foot height was significantly prolonged (P 0 05). Position prolongs the duration of ventricular repolarization, Damage to cardiac electrophysiological stability may increase the incidence of cardiovascular events.
【作者单位】：贵州医科大学麻醉学院;贵州医科大学附属医院麻醉科;
【基金】：贵阳市科技计划项目(编号:筑科合同[20151001]社31号)
【分类号】：R614

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