全麻下Trendelenburg体位腹腔镜手术麻醉风险评估及干预的研究进展

Research Progress on Anesthesia Risk Assessment and Intervention in Trendelenburg Position Laparoscopic Surgery under General Anesthesia

摘要: 腹腔镜手术已在临床实践上普遍应用，部分下腹部和盆部的手术需要Trendelenburg体位以达到更好的暴露效果，尤其是一些机器人辅助的腹腔镜手术甚至需要深度Trendelenburg位的配合。这种不符合正常生理的体位和人工气腹会对人体各个系统产生不利影响，以心血管和呼吸系统的影响最快，并且可能导致某些罕见并发症，如耳后出血、眩晕、脱发等，甚至可能危及生命。本文就与TP相关的麻醉风险及干预措施展开综述，可指导此类手术个体化预防措施，以保证患者围术期安全。

Abstract: Laparoscopic surgery has been commonly used in clinical practice, and some lower abdominal and pelvic procedures require the Trendelenburg position (TP) for better exposure, especially some robot-assisted laparoscopic procedures even require the deep Trendelenburg position. This unnat-ural physiological position and artificial pneumoperitoneum can adversely affect all systems of the body, with the cardiovascular and respiratory systems having the fastest impact. It may also lead to certain rare complications such as retroarticular hemorrhage, vertigo, and alopecia, which may even be life-threatening. This article presents a review of the anesthetic risks and interventions as-sociated with TP that can guide individualized preventive measures for such procedures to ensure patient safety in the preoperative period.