[1]王春玲,于江,田韵,等. 无气腹腹腔镜技术在宫内妊娠合并良性肿瘤中的应用[J].中国医学物理学杂志,2018,35(4):489-492.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.022]
　WANG Chunling,YU Jiang,TIAN Yun,et al. Application of gasless laparoscopic surgery in patients with intrauterine pregnancy and gynecologic benign tumor[J].Chinese Journal of Medical Physics,2018,35(4):489-492.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.022]
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 无气腹腹腔镜技术在宫内妊娠合并良性肿瘤中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第4期
页码:
489-492
栏目:
其他（激光医学等）
出版日期:
2018-04-21

文章信息/Info

Title:
 Application of gasless laparoscopic surgery in patients with intrauterine pregnancy and gynecologic benign tumor
文章编号:
1005-202X（2018）04-0489-04
作者:
 王春玲; 于江; 田韵; 俸珊
 解放军第181医院妇产科， 广西 桂林 541002
Author(s):
 WANG Chunling;  YU Jiang;  TIAN Yun;  FENG Shan
 Department of Obstetrics and Gynecology, 181st Hospital of Chinese People’s Liberation Army, Guilin 541002, China
关键词:
 ; 无气腹腹腔镜技术; 宫内妊娠; 妇科良性肿瘤
Keywords:
 ; gasless laparoscopic surgery;  intrauterine pregnancy;  gynecologic benign tumor
分类号:
R713
DOI:
DOI:10.3969/j.issn.1005-202X.2018.04.022
文献标志码:
A
摘要:
 目的：探讨无气腹腹腔镜技术在宫内妊娠合并妇科良性肿瘤手术中的有效性和安全性。 方法：选择80例宫内妊娠合并妇科良性肿瘤患者，随机将其分为对照组和观察组，各40例，对照组采用全身麻醉CO2腹腔镜手术，观察组采用硬膜外麻醉无气腹腔镜手术联合保胎治疗。观察指标包括手术前后血气分析和血流动力学变化、手术时间、术后排气时间、苏醒时间及心肺功能。 结果：两组患者动脉血氧分压、动脉血氧饱和度和pH值比较均无差异（P>0.05）；观察组术后动脉血二氧化碳分压和碱剩余值无明显变化，而对照组则明显升高（P<0.05），组间比较差异有统计学意义（P<0.05）。观察组术后平均收缩压、舒张压和心率与麻醉前比较均无差异（P>0.05），但对照组术后与麻醉前比较均明显升高（P<0.05），组间比较差异有统计学意义（P<0.05）。观察组手术时间、术后排气时间和苏醒时间均明显缩短，差异有统计学意义（P<0.05）。观察组未出现明显手术并发症，对照组共发生5例皮下气肿。观察组术后肺顺应性与麻醉前比较无差异（P>0.05），但对照组术后与麻醉前比较明显降低，差异有统计学意义（P<0.05），组间比较差异有统计学意义（P<0.05）。 结论：在硬膜外麻醉状态下无气腹腹腔镜技术对宫内妊娠患者心肺功能影响小，手术时间短，苏醒时间早，术后保胎成功率明显提高。
Abstract:
 Objective To study the therapeutic effect and safety of gasless laparoscopic surgery (GLS) in patients with intrauterine pregnancy accompanied by gynecologic benign tumor. Methods A total of 80 patients suffering from intrauterine pregnancy with gynecologic benign tumor were selected and randomly divided into control group and observation groups, with 40 cases in each group. The patients in control group received general anesthesia CO2 laparoscopic surgery, while those in observation group were treated with epidural anesthesia GLS combined with tocolytic therapy. The differences in arterial blood gas analysis, hemodynamic changes, operation time, postoperative exhaust time, recovery time and cardiopulmonary function influence were compared. Results No statistical differences were found in arterial partial oxygen pressure, oxygen saturation and pH value between the two groups (P>0.05). After operation, the carbon dioxide pressure, base excess, mean systolic blood pressure, diastolic blood pressure and heart rate in observation group didn’t showed any remarkable changes compared to those before anesthesia (P>0.05), while those indicators were all significantly higher in control group (P<0.05), and the differences between the two groups were statistically significant (P<0.05). The operation time, postoperative exhaust time and recovery time in observation group were shorter than those in control group (P<0.05). There were no severe complications in observation group, but 5 cases of subcutaneous emphysema occurred in control group. No statistical differences were found in lung compliance in observation group before anesthesia and after operation (P>0.05), while in control group, lung compliance after operation was significantly lower than that before anesthesia (P<0.05) and that in observation group (P<0.05). Conclusion GLS with epidural anesthesia for intrauterine pregnancy patients can bring less influence on cardiopulmonary function, shorten operation time and recovery time, and distinctly improve tocolytic success rate.

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备注/Memo

备注/Memo:
 【收稿日期】2017-10-14
【作者简介】王春玲，主治医师，E-mail: 2476803367@qq.com
【通信作者】俸珊，副主任医师，E-mail: 25462599@qq.com
更新日期/Last Update: 2018-04-23