在手术期间的液体分布平躺,Trendelenburg,和反向的Trendelenburg身体位置
1Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Acta anaesthesiologica Scandinavica
|May 30, 2024
概括
总麻醉会导致液体保留,特别是在血管外空间. 像Trendelenburg这样的外科位置显著改变了液体的分布和排泄,影响了患者的液体平衡.
科学领域:
- 麻醉学 麻醉学
- 生理学 生理学 生理学
- 手术科学 手术科学
背景情况:
- 全身麻醉会影响注入的晶体流体的分布和排泄.
- 手术位置 (Trendelenburg,反向Trendelenburg) 对这些流体动态的影响仍然不清楚.
研究的目的:
- 为了研究手术位置如何影响在全身麻醉下流体分配和排泄.
- 为了比较麻醉患者和清醒志愿者的流体动力学.
主要方法:
- 对61名手术患者和106名志愿者的血液稀释和尿液输出数据的回顾性分析.
- 在30-60分钟内注入1-2升林格溶液.
- 种群体积动态分析以比较流体分布参数.
主要成果:
- 一般麻醉显著降低了尿液输出速率常数 (79-91%) 和液体返回血速率常数 (15-70%),取决于位置.
- "抬腿"的位置促进了淋巴流动,而"抬头"则减缓了淋巴流动.
- 这两个Trendelenburg的位置都增加了"第三流体空间"的膨胀.
结论:
- 总麻醉促进液体保留,主要是在血管外空间.
- 手术位置改变了流体动力学,受到重力的影响.
- 麻醉引起的液体保留是通过腹腔镜手术加剧的.
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