在 laparoscopic 腹腔外科手术期间影响腹腔内压力变化的因素的评估
Hülya Tosun Söner1, Fatma Acil1, Ali Kendal Oğuz1
1Department of Anesthesiology and Reanimation, Gazi Yaşargil Training and Research Hospital, Health Science University, Diyarbakır, Turkey.
腹腔内管袖口压力在腹腔镜减肥手术期间大幅波动,特别是在腹腔灌气时. 建议定期监测这些压力,以防止喉疼痛和狭窄等并发症.
科学领域:
- 麻醉学 麻醉学
- 外科手术的安全性
- 患者监测 患者监测
背景情况:
- 气管袖子压力升高可能会危及气管粘膜输液,导致诸如喉疼痛,,下狭窄等并发症.
- 腹腔镜减肥手术涉及显著的生理变化,包括增加的腹内压力,这可能会影响内管袖口压力.
研究的目的:
- 调查影响腹腔镜减肥手术期间内管袖口压力变化的因素.
- 评估这个患者群体中袖口压力变化,手术阶段和气道压力之间的关系.
主要方法:
- 一项前性观察性研究,涉及27名接受腹腔镜减肥手术的患者.
- 收集的数据包括内肌袖子压力,气道压力,腹内压力,呼吸速率和手术台倾斜.
- 手术过程被分为四个不同的分析阶段:吸入前,吸入,桌子定位和吸出.
主要成果:
- 在输管后观察到过度膨胀袖口的高发病率 (92.59%).
- 内气管袖口压力在手术阶段之间表现出显著的变化,在腹腔灌气 (41.59 cmH2O) 期间达到峰值,并在抽气后 (29.81 cmH2O) 降低.
- 袖口压力变化与手术阶段有显著的相关性 (P<0.001),但与手术持续时间或气道压力峰值无关.
结论:
- 在腹腔镜减肥手术过程中,内肌袖子压力会发生显著和可预测的变化.
- 定期监测内管袖口压力对于有效管理和最大限度地减少术后呼吸道并发症至关重要.
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