Ido K, Suzuki T, Kimura K, Taniguchi Y, Kawamoto C, Isoda N, Nagamine N, Ioka T, Kumagai M, Hirayama Y
Department of Endoscopy, Jichi Medical School, Tochigi, Japan.
Surg Endosc. 1995 Mar;9(3):310-3. doi: 10.1007/BF00187775.
Lower-extremity venous stasis during laparoscopic cholecystectomy was evaluated in 16 patients by monitoring the blood velocity in the femoral vein and the femoral vein size (cross-sectional area) using color Doppler ultrasonography. The blood velocity in the femoral vein decreased significantly after the start of 10-mmHg abdominal insufflation in the supine position. When the patients were placed in a reverse Trendelenburg position during 10-mmHg insufflation, blood velocity in the femoral vein further decreased. However, velocity returned to the baseline after deflation. The cross-sectional area of the femoral vein was significantly elevated after the start of 10 mm Hg insufflation in the supine position. When patients were placed in the reverse Trendelenburg position during 10-mmHg insufflation, this parameter was further elevated, but returned to the baseline soon after deflation. These results indicate that femoral vein stasis during laparoscopic cholecystectomy can be minimized by reducing the pressure of abdominal insufflation and avoiding elevation of the patient's head as much as possible.
通过使用彩色多普勒超声监测股静脉中的血流速度和股静脉大小（横截面积），对16例患者在腹腔镜胆囊切除术期间的下肢静脉淤滞情况进行了评估。在仰卧位开始10mmHg的腹部充气后，股静脉中的血流速度显著降低。当患者在10mmHg充气期间处于头高脚低位时，股静脉中的血流速度进一步降低。然而，放气后血流速度恢复到基线水平。在仰卧位开始10mmHg充气后，股静脉的横截面积显著增大。当患者在10mmHg充气期间处于头高脚低位时，该参数进一步升高，但放气后很快恢复到基线水平。这些结果表明，通过降低腹部充气压力并尽可能避免抬高患者头部，可以将腹腔镜胆囊切除术期间的股静脉淤滞降至最低。
