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肥胖对光神经外直径的影响在腹腔镜妇科手术的患者中:一项前性观察性研究

Hyerim Kim¹, Taikyung Seol², Jee-Eun Chang¹

¹Department of Anesthesiology and Pain Medicine, College of Medicine, SMG-SNU Boramae Medical Center, Seoul National University, Boramae-Ro 5, Dongjak-gu, Seoul, 156-707, Republic of Korea.

Journal of anesthesia

|March 20, 2025

概括

在腹腔镜妇科手术期间,肥胖会增加视神经外直径 (ONSD),这表明内压力较高. 在肥胖患者中,ONSD的这种升高在手术后仍然存在,与非肥胖患者不同.

科学领域:

麻醉学麻醉学
神经外科神经外科
妇科外科手术妇科外科

背景情况:

用肺上皮管和的Trendelenburg定位进行 laparoscopic 妇科手术可以提高内压力.
通过超声波测量光神经外直径 (ONSD) 是估计内压力的非侵入性方法.
在这些程序期间肥胖对ONSD的影响尚未得到充分证实.

研究的目的:

评估肥胖对腹腔镜妇科手术患者的ONSD的影响.
为了比较手术期间和手术后肥胖和非肥胖患者之间的ONSD变化.

主要方法:

68名患者被分为非肥胖 (n=34) 和肥胖 (n=34) 组.
在多个时间点使用超声波测量了ONSD:手术前,肺上皮管/特伦登堡期间和排气后.
评估了手术后恶心和吐 (PONV) 和头痛的发生率.

主要成果:

在pneumoperitoneum和Trendelenburg定位期间,ONSD在两组中都显著增加.
与非肥胖患者相比,肥胖患者在整个外科手术期间表现出明显更高的ONSD.
在非肥胖患者中,增加的ONSD恢复到手术后24小时的基线,但在肥胖患者中仍然升高.
手术后1小时PONV的发病率在肥胖组显著高于肥胖组.

结论:

肥胖与腹腔镜妇科手术期间和之后的显著更高的ONSD有关.
肥胖患者的升高的ONSD可能不会在手术后24小时内消失,这表明对内压力的长期影响.
肥胖患者的早期术后恶心和吐的发病率较高.

关键词:

肥胖问题肥胖问题视神经外套的直径是肺部皮质子 (Pneumoperitoneum) 是一种在肺部中形成的.在Trendelenburg的位置上.

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