分析腹腔镜手术不同气腹压力对老年患者血气的影响

发布时间：2018-04-14 05:40

本文选题：腹腔镜手术 + 气腹压力　；参考：《临床医药文献电子杂志》2016年35期

【摘要】：目的分析腹腔镜手术中不同气腹压力对老年患者血气的影响情况。方法选取2014年1月~2016年3月在我院实施腹腔镜手术治疗且年龄在65岁以上的患者132例作为研究对象,将其随机分为甲组和乙组,各66例。甲组气腹压为10 mm Hg,乙组气腹压为14 mm Hg,对实施气腹前15 min(t0)、建立平卧位气腹后15 min(t1)、建立气腹且改变体位后15 min(t2)、30 min(t3)、1 h(t4)、2 h(t5)及气腹结束后且为平卧位后15 min(t6)的MAP与CVP,肺平均动脉压(MPAP)、肺动脉楔压(PCWP)、CO,并计算肺循环阻力(PVR)、体循环阻力(SVR)、CI,并抽取动脉血测定PaO_2、PaCO_2、pH值。结果两组患者在手术时间及手术一般情况方面不存在巨大差异,但与t0时进行对比,两组患者t1~t5时间段的PaCO_2、MPAP、PCWP、CVP、MAP值明显升高,差异有统计学意义(P0.05);ph值明显降低,差异有统计学意义(P0.05);在t2~t5时间段,乙组患者MPAP、PCWP、CVP、MAP、HR值均显著高于甲组,差异有统计学意义(P0.05)。结论 14 mm Hg的气腹压力对老年患者血气的影响大于10 mm Hg的气腹压力,老年患者应用腹腔镜手术应尽量选择低气腹压力。
[Abstract]:Objective to analyze the effect of different pneumoperitoneum pressure on blood gas in elderly patients.Methods from January 2014 to March 2016, 132 patients aged over 65 were randomly divided into two groups: group A (n = 66) and group B (n = 66).In group A, the pneumoperitoneum pressure was 10 mm Hg, and the pneumoperitoneum pressure in group B was 14 mm Hg. The MAP and CVP6 were observed in patients with pneumoperitoneum 15 min before pneumoperitoneum, 15 min after pneumoperitoneum in supine position, 15 min after establishing pneumoperitoneum and 30 min after changing body position, and 15 min after pneumoperitoneum and 15 min after supine position.Mean arterial pressure (MPAP), pulmonary wedge pressure (PCWP), pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) were calculated, and arterial blood samples were taken to determine Pao _ 2 Paco _ 2 pH value.Results there was no significant difference between the two groups in terms of operation time and general operation condition, but compared with the time of t 0, the map value of Paco _ 2 MPAPP _ (PCWP) CVPU in t1~t5 was significantly increased, the difference was statistically significant (P < 0.05) and the ph value of the two groups was significantly lower than that of the control group (P < 0.05), but there was no significant difference between the two groups in the operation time and the general operation condition.At the time of t2~t5, the HR values of the patients in group B were significantly higher than those in group A (P 0.05).Conclusion the effect of 14 mm Hg pneumoperitoneum pressure on blood gas in elderly patients is greater than that of 10 mm Hg pneumoperitoneum pressure.
【作者单位】：新疆伊宁市四师医院;
【分类号】：R614

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