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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2024, Vol. 13 ›› Issue (4): 285-288.doi: 10.3969/j.issn.2095-378X.2024.04.003

• 论著 • 上一篇    下一篇

超声引导下的肺复张策略对腹腔镜袖状胃切除术患者生命体征和术后不良反应的影响

吴宁1, 骆岳峰2, 林少锋1   

  1. 1.南方医科大学深圳医院麻醉科, 广东 深圳 518101;
    2.深圳市前海蛇口自贸区医院麻醉科, 广东 深圳 518052
  • 收稿日期:2024-07-16 出版日期:2024-12-28 发布日期:2025-01-09
  • 基金资助:
    深圳市宝安区医疗卫生科研项目（2023JD239）

Effects of ultrasound-guided lung recruitment strategy on vital signs and incidence of postoperative adverse reactions in patients undergoing laparoscopic sleeve gastrectomy

WU Ning1, LUO Yuefeng2, LIN Shaofeng1   

  1. 1. Department of Anesthesiology, Shenzhen Hospital of Southern Medical University, Shenzhen 518101, Guangdong, China;
    2. Department of Anesthesiology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen 518052, Guangdong, China
  • Received:2024-07-16 Online:2024-12-28 Published:2025-01-09

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摘要： 目的 观察腹腔镜袖状胃切除术患者予以超声引导下的肺复张策略对其生命体征和术后不良反应发生率的影响。方法 选取2020年3月—2024年3月行腹腔镜袖状胃切除术的80例患者,采用随机数字表法分为对照组和观察组,每组各40例。所有患者均实施静-吸复合麻醉。麻醉复苏时,对照组予以传统手法肺复张,观察组予以超声引导下的肺复张策略。对比两组患者麻醉诱导前5 min（T0）、手术结束肺复张前（T1）、复张后（T2）、拔管后30 min（T3）、术后1 d（T4）的血氧饱和度（SpO2）、平均动脉压（MAP）、心率（HR）、动脉血氧分压/吸入氧浓度（PaO2/FiO2）,统计两组术后不良反应（肺不张、肺炎、胸腔积液、低氧血症）发生率。结果 观察组术后不良反应总发生率显著低于对照组（P<0.05）。T0、T1时,两组间SpO2差异无统计学意义（P>0.05）;T2、T3、T4时,观察组SpO2较对照组显著增高（P<0.05）。T1、T2时,两组MAP和HR水平均较T0时显著下降（P<0.05）;T2、T3时,观察组和对照组间MAP和HR差异无统计学意义（P>0.05）。T2、T3、T4时,观察组PaO2/FiO2水平高于对照组（P<0.05）。结论 腹腔镜袖状胃切除术患者接受超声引导下的肺复张策略,其生命体征的稳定性不受影响,同时术后氧合作用得到改善,术后不良反应减少。

关键词: 腹腔镜袖状胃切除术, 超声, 肺复张, 生命体征, 不良反应

Abstract: Objective To observe the effect of ultrasound-guided lung recruitment strategy on vital signs and incidence of postoperative adverse reactions in patients undergoing laparoscopic sleeve gastrectomy. Methods Using a random number table,a total of 80 patients who underwent laparoscopic sleeve gastrectomy from March 2020 to March 2024 were selected and divided into two groups, with 40 patients in each group. Both groups received combined intravenous and inhalational anesthesia during surgery. On this basis, the control group received traditional lung recruitment maneuver during anesthesia recovery, while the observation group received ultrasound-guided lung recruitment strategy. Comparisons were conducted for the blood oxygen saturation （SpO2）, mean arterial pressure （MAP）, heart rate （HR）, and arterial oxygen partial pressure/fraction of inspiratory oxygen （PaO2/FiO2） of the two groups at 5 min before anesthesia induction （T0）, before lung recruitment at the end of surgery （T1）, after lung recruitment （T2）, 30 min after extubation （T3）, and 1 d after surgery （T4）. The incidences of postoperative adverse reactions （atelectasis, pneumonia, pleural effusion, hypoxemia） were analyzed in the two groups. Results The incidence rates of postoperative adverse reactions were lower in the observation group than in the control group （P<0.05）. At T0 and T1, the SpO2 levels between the two groups were not different （P>0.05）. At T2, T3, and T4, the SpO2 levels in the observation group were higher than those in the control group （P<0.05）. At T1 and T2, both groups showed a decrease in MAP and HR compared to T0 （P<0.05）. At T2 and T3, there was no significant difference in MAP and HR between the observation group and the control group （P>0.05）. At T2, T3, and T4, the PaO2/FiO2 levels in the observation group were higher than those in the control group （P<0.05）. Conclusion The ultrasound-guided lung recruitment strategy for patients undergoing laparoscopic sleeve gastrectomy does not affect the stability of vital signs, and can improve oxygenation and reduce postoperative adverse reactions.

Key words: Laparoscopic sleeve gastrectomy, Ultrasound, Pulmonary recruitment, Vital sign, Adverse reaction

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