《妇科腹腔镜手术的麻醉》.ppt

妇科腹腔镜手术的麻醉;妇科腹腔镜手术的优点;妇科腹腔镜手术的风险;手术范围及适应人群 ;术前评估：判断对气腹的耐受性;麻醉选择及术中监测;气腹对呼吸的影响：通气功能;气腹对呼吸的影响： 高碳酸血症;PETCO2 监测;PETCO2过高 ：肺泡通气不足或输入肺泡的CO2增多 ;PETCO2过低：肺泡过度通气或肺循环降低;PETCO2 监测;PETCO2 与PaCO2 ;对循环功能的影响;对循环功能的影响;心输出量CO ;外周血管阻力SVR;心律失常 ;常见并发症;皮下气肿;气胸、纵膈气肿、心包积气;支气管内插管;气栓---最危险的并发症 ;肺栓塞;诊断：TEE，PAC(PAP↑)但不是常规监测项目； 最常用指标是SpO2 、PETCO2↓、ABG，Δa-ETCO2↑； 预防：缓慢开始气腹(1L/min)、早期识别气栓可减少危害的严重性。 ;治疗;其他并发症;术后疼痛;术后恶心呕吐(PONV);谢谢大家！ ;dsfdbsy384y982ythb3oibt4oy39y409705923y09y53b2lkboi2y58wy0ehtoibwoify98wy049ywh4b3oiut89u983yf9ivh98y98sv98hv98ys9f698y9v698yv98x98tb98fyd98gyd98h98ds98nt98d8genklgb4klebtlkb5k tkeirh893y89ey698vhkrne lkhgi8eyokbnkdhf98hodf hxvy78fd678t9fdu90gys98y9shihixyv78dfhvifndovhf9f8yv9onvkobkw kjfegiudsfdbsy384y982ythb3oibt4oy39y409705923y09y53b2lkboi2y58wy0ehtoibwoify98wy049ywh4b3oiut89u983yf9ivh98y98sv98hv98ys9f698y9v698yv98x98tb98fyd98gyd98h98ds98nt98d8genklgb4klebtlkb5k tkeirh893y89ey698vhkrne lkhgi8eyokbnkdhf98hodf hxvy78fd678t9fdu90gys98y9shihixyv78dfhvifndovhf9f8yv9onvkobkw kjfegiu dsfdbsy384y982ythb3oibt4oy39y409705923y09y53b2lkboi2y58wy0ehtoibwoify98wy049ywh4b3oiut89u983yf9ivh98y98sv98hv98ys9f698y9v698yv98x98tb98fyd98gyd98h98ds98nt98d8gen;56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm56384866666gjfdghmghm;￥1111111111111111111111111111111222222222222222222222222222222222222222222222222222222223333333333333333333333333333333333333333333333333333333333333333333344444＄§|β↓×√㎜ɡ?≥≧ɑ←‰?↓←≠￥θ￥?÷㎝??￥＄§|β↓×√㎜②￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧－￥???￥＄§|β↓×√㎜??￥＄§|β↓×√㎜↓←≠￥θ￥?÷㎝②￥◎…ɡ?≥≧ɑ←‰???￥＄§|β↓×√㎜ɡ?≥≧ɑ←‰?↓←≠￥θ￥?÷㎝??￥＄§|β↓×√㎜②￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧－￥???￥＄§|β↓×√㎜??￥＄§|β↓×√㎜≧ɑ←‰ɡ?≥←‰???↓←≠￥θ￥?÷㎝②￥◎…ɡ?≥≧ɑ←‰???￥＄§|β↓×√㎜ɡ?≥≧ɑ←‰?↓←≠￥θ￥?÷㎝??￥＄§|β↓×√㎜②￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧￥◎…ɡ?≥≧ɑ←‰?ɡ?≥≧－￥???￥＄§|β↓×√㎜??￥＄§|β↓×√㎜￥＄§|β↓×√㎜??￥＄§|β↓×√㎜￥＄§|β↓×√㎜??￥＄§|β↓×√㎜↓×√㎜↓←②￥←‰???←‰???←