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使用Trendelenburg位置进行机器人辅助腹腔镜手术对短期术后呼吸道隔膜功能的影响

Shuo Xue¹, Dan Wang¹, Hong-Qin Tu¹

¹Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 of Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.

BMC anesthesiology

|March 5, 2024

概括

在Trendelenburg位置的机器人辅助手术显著损害了手术后的隔膜功能. 升高的CC16表明潜在的肺损伤,可能是由于延长的肺上皮和定位.

科学领域:

麻醉学麻醉学
胸部外科手术胸部外科手术
手术机器人手术机器人手术机器人手术机器人

背景情况:

在Trendelenburg位置的机器人辅助腹腔镜手术 (RALS) 涉及肺上,可能会影响呼吸机制和隔膜功能.
了解这些术后影响对于患者安全和优化外科手术方案至关重要.

研究的目的:

为了研究在RALS期间Trendelenburg位置下的肺上皮质对外科手术期间呼吸系统参数和隔膜功能的影响.
通过测量手术后的血清生物标志物 (CC16和SP-D) 来评估潜在的肺损伤.

主要方法:

涉及在Trendelenburg位置接受RALS患者的比较研究与躺卧的整体手术.
在手术期间记录了呼吸系统参数 (肺部顺应,氧化指数,气道压力).
隔膜外流 (DE) 和隔膜加厚率 (DTF) 在多个时间点测量.
在手术前和后分析了克拉拉细胞分泌蛋白16 (CC16) 和表面活性蛋白D (SP-D) 的血清水平.

主要成果:

与一般手术组相比,RALS组的气道压力显著增加,肺部的服从性更低.
在RALS组中,术后的隔膜外流 (DE) 显著减少,持续到PACU排出.
机器人辅助手术增加了术后血清CC16水平,表明潜在的肺损伤,而这两种手术类型降低了SP-D水平.

结论:

在Trendelenburg位置上的RALS显著损害了手术后的隔膜功能,在PACU释放时恢复不完全.
在RALS后的CC16水平升高表明潜在的肺损伤,可能与长时间的Trendelenburg定位和肺关节有关.
这些发现凸显了在RALS.期间需要策略来缓解呼吸道和腹膜损害的需要.

关键词:

气道压力是指气道的压力.隔膜超声波隔膜超声波隔膜超声波肺部符合肺部的要求肺部损伤肺部损伤肺部损伤机器人辅助腹腔镜外科手术

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