在接受腹腔镜减肥手术的肥胖患者中,Atelectasis在从麻醉后护理单位出院后不会增加
Matthias Braun1, Lea Ruscher2, Alexander Fuchs2,3
1Department of Anaesthesiology, Lindenhof Hospital, Bern, Switzerland.
Frontiers in medicine
|September 20, 2023
概括
经过腹腔镜减肥手术的肥胖患者在麻醉后没有增加呼吸不良的肺部区域. 电阻断层扫描 (EIT) 证实肺部区域稳定,表明没有显著的术后肺部并发症.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 医疗成像医学成像
背景情况:
- 肥胖症增加了在全身麻醉期间,尤其是腹腔镜手术中,肺部脱氧的风险.
- 腹腔镜减肥手术在肥胖患者的肺功能维持方面提出了独特的挑战.
- 肺部并发症是这一患者群体的一个重大问题.
研究的目的:
- 评估在接受腹腔镜减肥手术的肥胖患者中肺动力学.
- 在外科手术期间使用电阻断层扫描 (EIT) 评估肺透气.
- 为了比较在麻醉前和在麻醉后护理单位 (PACU) 康复后的肺呼吸.
主要方法:
- 前性,观察性,单中心研究.
- 包括BMI≥40和ASA身体状况I-IV的成年患者.
- 排除患有严重肺高血压,家庭使用氧气,心力衰竭或最近肺部感染的患者.
- 主要结局:空气通风不足的肺部区域 (低潮变化区域) 的比例和EIT测量的全球不均质指数 (GI).
主要成果:
- 与手术前相比,低潮变化区域的比例在术后没有显著增加 (-0.7%的差异,p=0.022).
- 排气措施保持在预定义的非劣势差额之内.
- 在手术后的14天内没有观察到术后肺部并发症.
结论:
- 与手术前状态相比,接受腹腔镜腹手术的肥胖患者在PACU排出时没有增加呼吸不良的肺部区域.
- 经过EIT的监测,该群体的肺透气动态呈现稳定.
- 这些发现支持腹腔镜减肥手术对于肥胖患者的外科手术期间的肺脱氧症的安全性.
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