Objective To explore the impact of different levels of positive end expiratory pressure(PEEP)on central venous pres-sure(CVP)in patients undergoing laparoscopic partial hepatectomy.Method 81 patients who underwent laparoscopic partial hepatec-tomy admitted to our hospital from November 2021 to November 2022 were selected as the research subjects.They were divided into groups based on different PEEP values used during the surgery:Group A(27 cases)implemented a ventilation mode of low tidal vol-ume 6 ml/kg PBW,PEEP 0 cmH2 O;Group B(27 cases)implemented a ventilation mode of low tidal volume 6 ml/kg PBW,PEEP 0 cmH2 O;Group C(27 cases)implemented a ventilation mode of low tidal volume 6 ml/kg PBW,PEEP 8 cmH2 O.Record and com-pare the CVP,mean arterial pressure(MAP),and peak airway pressure of three different body positions at different time points:su-pine position after intubation(T0),supine position after pneumoperitoneum(T1),reverse Trendelenburg position after pneumoperito-neum(T2),and supine position after surgery(T3);Compare the intraoperative bleeding volume,red blood cell infusion volume,and plasma infusion volume among the three groups;Observe and compare the incidence of adverse reactions during the perioperative period among the three groups.Results There was no significant difference in CVP between the three groups of T0 and T3(P＞0.05).At T1 and T2,the CVP of Group A was lower than that of Group B,and Group B was lower than that of Group C.The difference between the three groups was statistically significant(P＜0.05);There was no significant difference in MAP among the three groups at T0,T1,T2,and T3(P＞0.05).Group A had lower peak airway pressure at T0,T1,and T2 than Group B,while Group B had lower peak air-way pressure than Group C.The difference between the three groups was statistically significant(P＜0.05),and there was no signifi-cant difference in peak airway pressure at T3(P＞0.05);There was no significant difference in intraoperative bleeding volume,red blood cell infusion volume,and plasma infusion volume among the three groups(P＞0.05);The incidence of adverse reactions in Group B was lower than those of Group A and Group C,with a statistically significant difference(P＜0.05).Conclusion The imple-mentation of PEEP 4 cmH2 O ventilation mode in laparoscopic partial hepatectomy has a more positive effect,can stabilize the patient's intraoperative CVP to a certain extent,and is beneficial for reducing or preventing adverse reactions.
Different levels of positive end expiratory pressureLaparoscopic partial hepatectomyCentral venous pressureMean arterial pressureAirway peak pressure
维普
万方数据
