【摘要】 目的：探讨改良Z字形屈氏位应用于腹腔镜子宫内膜癌（EC）根治术患者的效果及对患者眼压、生命体征的影响。方法：选择2019年6月-2021年12月南平市第一医院行腹腔镜EC根治术的86例患者作为观察对象，按便利抽样法分为A组和B组，各43例。A组手术体位选择屈氏位（头低足高截石位），B组选择改良Z字形屈氏位。对比两组患者的生命体征、眼压、肩部疼痛程度、下肢疼痛麻木程度。结果：建立气腹前（T₀）、气腹后30 min（T₁）、气腹后60 min（T₂）、恢复水平体位后1 min（T₃），两组心率、平均动脉压（MAP）对比差异无统计学意义（P>0.05）。T₀时，两组中心静脉压、体循环阻力对比差异无统计学意义（P>0.05）,T₀、T₁、T₂时，B组中心静脉压低于A组（P<0.05），两组体循环阻力比较差异无统计学意义（P>0.05）。T₁、T₂、T₃时，B组眼压低于A组（P<0.05）。麻醉清醒后（T₄）、术后1 d（T₅）、术后2 d（T₆）,B组肩部疼痛程度低于A组（P<0.05）;B组下肢疼痛麻木程度低于A组（P<0.05）。结论：腹腔镜EC根治术患者术中选择改良Z字形屈氏位接受手术，能降低中心静脉压和眼压，有助于稳定术中血流动力学，减少对体循环、心率、血压的影响。更多还原

【Abstract】 Objective: To investigate the effect of the modified Z Trendelenburg position in patients with laparoscopic endometrial cancer（EC） radical resection and its influence on intraocular pressure and vital signs. Method: From June 2019 to December 2021, 86patients who underwent laparoscopic EC radical operation in the Nanping First Hospital were selected as the observation objects, and were divided into group A and group B according to convenience sampling method, with 43 cases in each. The surgical position of group A was Trendelenburg position（low head and high foot lithotomy position）, and the group B was modified Z Trendelenburg position. The vital signs, intraocular pressure, shoulder pain, and lower limb pain were compared between the two groups. Result: Before pneumoperitoneum（T₀）, 30 min after pneumoperitoneum（T₁）, 60 min after pneumoperitoneum（T₂）, and 1 min after returning to the horizontal position（T₃）,there were no significant differences in heart rate and mean arterial pressure（MAP） between the two groups（P>0.05）. At T₀, there were no significant differences in central venous pressure and systemic vascular resistance between the two groups（P>0.05）. At T₀, T₁, T₂, the central venous pressure of group B was lower than that of group A（P<0.05）, and there were no significant differences in systemic vascular resistance between the two groups（P>0.05）. At T₁, T₂, T₃, the intraocular pressure of group B was lower than that of group A（P<0.05）.After awakening from anesthesia（T₄）, postoperative 1 d（T₅）, and postoperative 2 d（T₆）, the pain degree of shoulder in group B was lower than that in group A（P<0.05）; the pain degree of lower limb in group B was lower than that in group A（P<0.05）. Conclusion: Patients undergoing laparoscopic EC radical resection choose the modified Z Trendelenburg position for surgery, which can reduce central venous pressure and intraocular pressure, help to stabilize intraoperative hemodynamics, and reduce the impact on systemic circulation, heart rate and blood pressure.更多还原