腹腔镜胆囊切除术患者腹腔积气对踝肱指数的影响:一项观察性研究

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Ravneet Kaur Gill, Ashish Gupta, Prabhjot Kaur, Bharti Sidhu, Puja Saxena, Navdeep Singh Saini, Money Gupta
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引用次数: 0

摘要

背景:围手术期护理的改善导致微创手术的使用越来越多。微创手术期间的多种生理变化可归因于腹腔积气的产生:在印度北部一家三级医院接受腹腔镜胆囊切除术的 109 名患者均符合纳入和排除标准:在109名患者中,男性13名,女性96名(男:女=1:7.3),平均基础代谢率为28.95 kg/m2。上肢收缩压和舒张压的平均值分别为 134.33 + 17.545 和 80.69 + 11.59。下肢(LL)的平均收缩压和舒张压分别为 142.32 + 21.552 和 79.44 + 11.94。在建立腹腔积气和改变手术体位时,下肢的收缩压明显升高(P < 0.05)。在建立腹腔积气、诱导、反转 Trendelenburg 体位和拔管后,LL 舒张压明显升高(P < 0.05)。腹腔积气后,LL 的平均动脉压明显升高,并持续到拔管(P < 0.05)。腹腔积气后,患者的踝肱指数(ABI)明显升高,直到手术开始 15 分钟后仍有明显升高(P < 0.05)。根据皮尔逊相关性,ABI 与患者的体重和年龄没有相关性:结论:腹腔镜胆囊切除术患者的 ABI 在腹腔积气形成时、 Trendelenburg 体位后和手术开始 15 分钟内均有所上升。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Pneumoperitoneum on the Ankle-brachial Index of the Patients Undergoing Laparoscopic Cholecystectomy: An Observational Study.

Background: Improvement in the perioperative care has led to increased use of minimally invasive surgeries. Multiple physiological changes during minimally invasive surgeries are attributed to the creation of pneumoperitoneum.

Materials and methods: One hundred and nine patients who underwent laparoscopic cholecystectomy at a tertiary care hospital in north India meeting the inclusion and exclusion criteria were enrolled.

Results: Out of the total 109 patients, 13 were males and 96 females (M:F = 1:7.3), the mean basal metabolic rate was 28.95 kg/m2. The mean systolic and diastolic blood pressure of the upper limb were 134.33 + 17.545 and 80.69 + 11.59 respectively. The mean systolic and diastolic blood pressure in lower limb (LL) were 142.32 + 21.552 and 79.44 + 11.94, respectively. Significant rise in the SBP was noticed in LL at the time of creation of Pneumoperitoneum and after changing the position for surgery (P < 0.05). The diastolic pressure in the LL rises significantly in the LL after creation of pneumoperitoneum, at induction, after reverse Trendelenburg position and extubation (P < 0.05). The mean arterial pressure increased significantly in the LL after the creation of pneumoperitoneum and persisted till the extubation (P < 0.05). A significant rise of ankle-brachial index (ABI) was observed in the patients after the creation of pneumoperitoneum and it remained significant till 15 min into surgery (P < 0.05). There was no correlation of ABI with weight and age of the patients on Pearson correlation.

Conclusion: There is rise in ABI of the patients undergoing laparoscopic cholecystectomy at the time of creation of pneumoperitoneum, after Trendelenburg position and 15 min into surgery.

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