不同体位对腹腔镜下子宫肌瘤剔除术患者呼吸循环功能及术后并发症的影响

摘要

Objective To explore the change of the position of laparoscopy downward uterine fibroids eliminate perform‐er on the respiratory function and the effect of postoperative complications .Methods Choose 90 patients February 2010 to January 2010 with uterine fibroids rejecting operation as the research objects and randomly divided into group A (30 cases) and group B (30 cases) and C group (30 cases) .Patients in group A with horizontal supine while lateral position in group B , bladder cut stone in group C .Record the patient's heart rate ,mean arterial pressure ,pulse oxygen saturation ,breathing at the end of the carbon dioxide ,the airway peak pressure value ,observe the surgery time ,awakening time and postoperative complications 5 min after set the position 45 min ,15 min ,30 min .Results The comparative differences in Operation time , wake up of time ,postoperative complications ,heart rate ,mean arterial pressure at each time point between groups had no obvious statistical significance (P > 0 .05) .The comparison in mean arterial pressure in Group B ,group C had significant statistical significance (P 0 .05) .The airway peak pressure value in group B for 15 min ,30 min compared with 5 min significantly increased (P < 0 .05) .Conclusion Laparoscopic uterine fibroids eliminate intraoperative position changes on operation time ,wake up of time ,complications ,similar to the influence of heart rate and mean arterial pressure ,the impact on the patients with respiratory function is the largest .%目的：探讨不同体位对腹腔镜下行子宫肌瘤剔除术患者呼吸循环功能及术后并发症的影响。方法选择2010年2月～2015年1月我院收治的子宫肌瘤，且行子宫肌瘤剔除术患者90例为研究对象，随机分为A组、B组和C组，各30例。A组采用水平仰卧位，B组采用侧卧位，C组采用膀胱截石位。在摆好体位后5 min、15 min、30 min和45 min ，记录患者心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SPO2）、呼气末二氧化碳分压（PET CO2）、气道峰压值（Ppeak），观察手术时间、苏醒时间和术后并发症情况。结果三组手术时间、苏醒时间、术后并发症以及各时间点 HR、MAP比较无显著性差异（P＞0．05）；B组、C组15 min、30 minMAP与5 min比较有显著性差异（P＜0．05）；B组15 min、30 min PET CO2、Ppeak高于A组和C组（P＜0．05），A组与C组比较无显著性差异（P＞0．05）；B组15 min、30 min Ppeak与5 min比较明显升高（P＜0．05）；三组15 min、30 min PET CO2与5 min比较明显升高（P＜0．05）。结论腹腔镜下行子宫肌瘤剔除术体位变化对手术时间、苏醒时间、并发症、HR和MAP的影响相似，对患者呼吸功能的影响最大。