摘要: |
目的:探讨腹腔镜和经腹宫颈癌根治术术后气道变化的情况及相关因素。方法:选择美国麻醉医师协会(ASA)Ⅰ~Ⅱ级择期行腹腔镜和经腹宫颈癌根治术的患者各20例。记录两组患者术前、术后1 h、术后24 h的麦氏评分、咬唇试验和颈围,分析三者与术中气道压和中心静脉压的关系。结果:腹腔镜组与经腹组患者麦氏评分、咬唇试验和颈围在术前、术后1 h和术后24 h差异均无统计学意义。腹腔镜组患者术后1 h麦氏评分(P=0.001)、咬唇试验结果(P=0.003)与术前差异均有统计学意义,术后24 h麦氏评分、咬唇试验结果与术前差异均无统计学意义;腹腔镜组患者颈围术后1 h[(34.18±2.50) cm]、术后24 h[(32.98±2.30) cm ]与术前[(32.48±2.58) cm]差异均有统计学意义(P<0.05)。经腹组术后1 h和术后24 h麦氏评分、咬唇试验及颈围与术前差异均无统计学意义。术后1 h麦氏评分与手术开始后1 h、2 h气道压及手术开始后1 h中心静脉压正相关(P<0.05),而术后1 h咬唇试验与手术开始后1 h、2 h、3 h气道压及手术开始后2 h中心静脉压正相关(P<0.05)。结论:与经腹宫颈癌根治术相比较,腹腔镜下宫颈癌根治术术后早期气道变化明显,并且这种气道变化可能与术中早期气道压和中心静脉压有关。 |
关键词: 气道变化 麦氏评分 咬唇试验 颈围 |
DOI:10.12025/j.issn.1008-6358.2017.20161135 |
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Abstract: |
Objective:To analyze the reason which cause the different change of airway appearance after laparoscopic radical resection and transabdominal radical resection for cervical cancer. Methods:Patients with ASAⅠ Ⅱ,twenty undergoing laparoscopic radical resection of cervical cancer and twenty with transabdominal radical resection of cervical cancer were enrolled. The parameters of Mallampati class, class of upper lip bite test, and neck circumference were measured pre surgery, 1 h after and 24 h after surgery. The correlation between these three parameters and airway pressure or central venous pressure were analyzed. Results:The parameters of Mallampati class, class of upper lip bite test, and neck circumference showed no statistical significance between laparoscopic group and transabdominal group at each time. The statistical significances were found between the parameter of Mallampati class (P=0.001) and class of upper lip bite test (P=0.003) 1 h after surgery and before surgery, while no parameters significantly changed between 24 h after surgery and before surgery. The parameter of neck circumference in laparoscopic treatment group statistically changed 1 h ([34.18±2.50] cm) and 24 h ([32.98±2.30] cm) after surgery than before surgery ([32.48±2.58] cm, P<0.05). In transabdominal group, no statistical difference was found in the parameters of Mallampati class , class of upper lip bite test and neck circumference at 1 h or 24 h after surgery. In the group of laparoscopic treatment, Mallampati class 1 h after surgery was positively related to the airway pressure at 1 h and 2 h after beginning of surgery and central venous pressure at 1 h after beginning of surgery(P<0.05). There were also positive correlation of class of upper lip bite test 1 h after surgery and airway pressure at 1 h, 2 h and 3 h after beginning of surgery and central venous pressure at 2 h after beginning of surgery (P<0.05). Conclusions:Compared with the transabdominal radical resection, in laparoscopic radical resection, there are significant changes of airway at 1 h after surgery, which related to the airway pressure and central venous pressure at the beginning of surgery. |
Key words: airway change mallampati class upper lip bite test neck circumference |