發(fā)布時間：2018-05-12 19:05

  本文選題：機器人輔助手術(shù) + 前列腺癌根治術(shù)��； 參考：《實用醫(yī)學雜志》2017年06期

【摘要】：目的:觀察機器人輔助下前列腺癌根治術(shù)(RALRP)中過度通氣策略對患者頸靜脈球壓力(JBP)和視神經(jīng)鞘直徑(ONSD)的影響。方法:擇期行RALRP患者20例,全身麻醉后過度通氣,記錄插管后5 min(T_0)、Trendelenburg體位后15 min(T_1)、建立氣腹30、60、90 min(T_2、T_3、T_4)和停氣腹平臥后15 min(T_5)呼吸末二氧化碳(ETCO_2)、動脈血氧分壓(PaO_2)、動脈血二氧化碳分壓(PaCO_2)、氣道峰壓(PIP)、JBP和ONSD的變化。結(jié)果:與T_0比較,T1~T5時間點JBP升高(P0.05)。過度通氣期間T_1~T_5的ETCO_2和PaCO_2較T_0降低(P0.05)。Trendelenburg體位和氣腹建立后,PIP值T_1~T_4較T_0升高(P0.05),但ONSD在T_3~T_5各較T_1~T_2升高(P0.05)。結(jié)論:RALRP中采用過度通氣,建立氣腹及Trendelenburg體位后患者JBP和PIP增高,ONSD逐漸增寬。
[Abstract]:Objective: to observe the effect of hyperventilation strategy on jugular bulbar pressure (JBP) and optic nerve sheath diameter (ONSD) in robotic assisted radical prostatectomy for prostate cancer (RALRP). Methods: twenty patients with RALRP were treated with hyperventilation after general anesthesia. Five minutes after intubation, 15 mins after the posture of Trendelenburg, 15 mins after the establishment of the pneumoperitoneum, 306090 mins of the pneumoperitoneum were established. The level of T _ 2T _ 3T _ 4) and 15 min after the cessation of pneumoperitoneum were recorded.) the changes of end-respiratory carbon dioxide (ETCO _ 2), arterial partial pressure of oxygen (Pao _ 2), partial pressure of arterial carbon dioxide (Paco _ 2T _ 2), peak airway pressure (PIP) and ONSD were recorded. Results: compared with T _ 0, JBP of T _ 1 T _ 5 increased P 0.05. During hyperventilation, the ETCO_2 and PaCO_2 of T_1~T_5 were lower than that of T _ (0). The values of ETCO_2 and PaCO_2 in T_1~T_5 were significantly higher than those in T _ (0) after postural and pneumoperitoneum establishment, but ONSD in T_3~T_5 was higher than that in T_1~T_2, respectively. Conclusion the JBP and PIP of the patients with hyperventilation were increased after establishing pneumoperitoneum and Trendelenburg position.
【作者單位】： 四川省醫(yī)學科學院·四川省人民醫(yī)院麻醉科;
【基金】：四川省衛(wèi)生和計劃生育委員會科研課題(編號:16PJ459)
【分類號】：R737.25;R614

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