摘要
目的探索腹腔镜手术中CO2气腹和头低足高体位对老年直肠癌患者循环功能的影响。方法回顾性分析48例老年直肠癌患者在麻醉前(T1),麻醉后(T2),建立气腹后(T3),摆放头低足高位后(T4),手术开始后30(T5)、60(T6)、90(T7)及120 min(T8)时的(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)、心脏指数(CI)、中心静脉压(CVP)、p H、动脉血氧分压(Pa O2)及动脉血CO2分压(Pa CO2)资料,探索腹腔镜手术中CO2气腹和头低足高体位对老年直肠癌患者循环功能的影响。结果重复测量资料的方差分析结果显示,HR、SBP、DBP、MAP、CO、CI、p H、Pa O2及Pa CO2的时间效应均无统计学意义(P>0.05);而CVP的时间效应具有统计学意义(P<0.05),与T1和T2时间点比较,T7和T8时间点的CVP值均较高(P<0.05)。结论对于老年直肠癌患者实施腹腔镜手术时,患者的CVP随着手术时间的延长会逐渐升高,但积极做好术前评估和基础疾病的治疗控制、加强围手术期管理后,腹腔镜手术对于老年直肠癌患者是比较安全的。
Objective To explore the effects of CO2 pneumoperitoneum and posture on circulation function for elderly patients with rectal cancer during laparoscopic operation. Methods Retrospective analysis of clinical data of 48 elderly patients with rectal cancer was performed, and the data included the heart rate（HR）, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, mean arterial pressure（MAP）, cardiac output（CO）, cardiac index（CI）, central venous pressure（CVP）, p H, partial pressure of oxygen（Pa O2）, and partial pressure of carbon dioxide（Pa CO2） at before anesthesia（T1）, after anesthesia（T2）, after the establishment of CO2 pneumoperitoneum（T3）, placement in trendelenburg position after operation（T4）, 30 minutes after operation（T5）, 60 minutes after operation（T6）, 90 minutes after operation（T7）, and 120 minutes after operation（T8）. Results The levels of HR, SBP, DBP, MAP, CO, CI, p H, Pa O2, and Pa CO2 at8 time points didn’t statistically differed with each other（P〉0.05）, but the levels of CVP at T7 and T8 time point were significantly higher than those of T1 and T2 time point（P〈0.05）. Conclusions During laparoscopic operation period for the elderly patients with rectal cancer, the CVP will gradually increase. If the preoperative assessment and administration are done well during peri-operation period, laparoscopic operation is safe for the elderly patients with rectal cancer.
出处
《中国普外基础与临床杂志》
CAS
2015年第3期331-334,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
老年患者
直肠癌
腹腔镜手术
循环功能
Elderly patient
Rectal cancer
Laparoscopic operation
Circulation function
