【摘要】 目的比较妇科无气腹悬吊式腹腔镜与气腹腹腔镜手术对卵巢手术患者术中心率变异性的影响。方法选择行腹腔镜下卵巢肿瘤切除术患者50例,美国麻醉师学会(ASA)分级Ⅰ～Ⅱ级,按患者意愿分成两组,每组25例。Ⅰ组于全麻下行CO2气腹腹腔镜手术;Ⅱ组于全麻下行悬吊式腹腔镜手术。监测两组患者麻醉前(T1)、气腹或悬吊建立后到气腹或悬吊撤除(T2)、气腹或悬吊撤除后20min(T3)和术后次日08:00～10:00(T4)4个时段心率变异性的各项指标。结果 T1、T4两组时段心率变异性的各项指标比较差异无统计学意义(P>0.05)。T2、T3两组时段心率变异性的各项指标比较差异有统计学意义(P<0.05)。结论悬吊式腹腔镜技术有利于心率改变患者术中心血管系统功能的稳定,有利于降低患者术中心血管事件发生。更多还原

【Abstract】 Objective To compare the effects of carbon dioxide pneumoperitoneum or gasless laparoscopy on the heart rate variability(HRV) during ovarian laparoscopy operation in gynecologic patients.Methods Fifty patients undergoing elective ovarian tumor operation from July 2009 to February 2010 in our hospital were selected,ASA Ⅰ-Ⅱand the operation time within 120 min,and divided into two groups(Ⅰand Ⅱ) according to patient′s willingness,25 cases in each group.The groupⅠwas performed CO2 pneumoperitoneum under general anesthesia,while the group Ⅱ was performed gasless laparoscopy under general anesthesia.The indexes of HRV at pre-anesthesia(T1),the abdominal wall-lifting or CO2 insufflation establishing to its removal(T2),20 min after the abdominal wall-lifting or CO2 insufflation removal(T3) and 8 to 10 o′clock in the first postoperative morning(T4) were monitored in the two groups.Results There were no differences between these two groups in T1 and T4 time period(P>0.05).There were significant differences in T2,T3 time period between these two groups(P<0.05),especially in T2 time period.The LF and LF/HF were significantly increased in the groupⅠ.In T3 time period,the LF and LF/HF were decreased somewhat in the groupⅠ.But there were significant differences between these two groups.Conclusion Abdominal wall-lifting methods have beneficial to the patients with HRV changes in the stability of the system function,help to reduce cardiovascular events in patients with surgery.更多还原