Torrielli R, Cesarini M, Winnock S, Cabiro C, Mene J M
Département d'Anesthésie-Réanimation, C.H.U. Hopital Pellegrin, Bordeaux.
Can J Anaesth. 1990 Jan;37(1):46-51.
In 18 women A.S.A. physical status 1, a noninvasive thoracic electrical bioimpedance method was used to evaluate haemodynamic changes during gynaecological laparoscopy. A significant decrease in cardiac index was observed after peritoneal insufflation, from 3.2 to 2.8 L.min-1.m-2 and returned to the initial values after ten minutes of Trendelenburg's position. Elevated intra-abdominal pressure was also associated with a significant increase in mean arterial pressure (from 68 to 88 mmHg) and systemic vascular resistance index (from 1620 to 2491 dyn.s.cm-5.m-2). However, values were not restored after peritoneal exsufflation: systemic vascular resistance index values remained 30 per cent higher than that before insufflation. Decreased venous return may account for the significant decrease in cardiac output but mechanical compression does not explain the persistent elevation of systemic vascular resistance.
在18例美国麻醉医师协会（ASA）身体状况为1级的女性患者中，采用非侵入性胸电阻抗法评估妇科腹腔镜检查期间的血流动力学变化。气腹后观察到心脏指数显著下降，从3.2降至2.8L·min⁻¹·m⁻²，在头低脚高位10分钟后恢复至初始值。腹腔内压力升高还与平均动脉压显著升高（从68mmHg升至88mmHg）和全身血管阻力指数显著升高（从1620dyn·s·cm⁻⁵·m⁻²升至2491dyn·s·cm⁻⁵·m⁻²）相关。然而，放气后这些值并未恢复：全身血管阻力指数值仍比充气前高30%。静脉回流减少可能是心输出量显著下降的原因，但机械压迫并不能解释全身血管阻力的持续升高。
