تأثیر فازهای قاعدگی بر تغییرات همودینامیک بیماران در حین جراحی کوله سیستکتومی لاپاراسکوپیک

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 استادیار گروه بیهوشی، دانشکده پزشکی، دانشگاه آزاد علوم پزشکی، تبریز، ایران.

3 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 استادیار گروه جراحی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: نتایج متناقضی در زمینه اثرات سیکل قاعدگی بر تغییرات فشار خون، ضربان قلب، تهویه و هورمون اکسی­توسین در حین بیهوشی بیماران کاندید جراحی کوله سیستکتومی لاپاراسکوپیک وجود دارد؛ لذا مطالعه حاضر با هدف بررسی تأثیر قاعدگی بر تغییرات همودینامیک بیماران در حین جراحی کوله سیستکتومی لاپاراسکوپیک انجام شد.
روش‌کار: این مطالعه توصیفی مقطعی در سال 1397 بر روی 100 نفر از بیماران کاندید جراحی کوله سیستکتومی لاپاراسکوپیک مراجعه کننده به بیمارستان امام رضا (وابسته به دانشگاه علوم پزشکی تبریز) انجام شد. بیماران به دو گروه فاز لوتئال و فاز فولیکولار تقسیم شدند و وضعیت همودینامیک (ضربان قلب، فشار خون، میزان اشباع اکسیژن شریانی و CO2 انتهای بازدمی) بین آنان مقایسه شد. اطلاعات دموگرافیک و وضعیت همودینامیک قبل و حین بیهوشی در چک‌لیست محقق ساخته وارد شد. تجزیه و تحلیل داده ­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون­ های تی تست، کای اسکوئر و آزمون اندازه‌گیری­ های تکراری استفاده شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: بر اساس نتایج آزمون تی تست، بین دو گروه در هیچ یک از زمان ­ها اختلاف آماری معناداری در میزان متوسط فشار شریانی، CO2 انتهای بازدمی و میزان اشباع اکسیژن شریانی وجود نداشت (05/0˃p)، اما بر اساس نتایج آزمون اندازه‌گیری‌های تکراری، تغییرات متوسط فشار شریانی در طی مطالعه در گروه فاز فولیکولار (031/0=p) نسبت به گروه فاز لوتئال (059/0=p) به‌طور معناداری بیشتر بود. همچنین بر اساس آزمون تی تست، مقایسه وضعیت ضربان قلب بین دو گروه در هیچ یک از زمان­ ها اختلاف آماری معناداری نشان نداد (05/0˃p)؛ بر اساس نتایج آزمون اندازه‌گیری­ های تکراری، تغییرات ضربان قلب در طی مطالعه در گروه فاز فولیکولار (019/0=p) نسبت به گروه فاز لوتئال (126/0=p) به‌طور معناداری بیشتر بود.
نتیجه­ گیری: چرخه قاعدگی، اثرات قابل‌توجهی بر پارامترهای همودینامیک حین بیهوشی در بیماران کاندید کوله سیستکتومی لاپاراسکوپیک دارد که این تغییرات در طول فاز فولیکولی در مقایسه با فاز لوتئال بارزتر می‌باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of menstrual phases on hemodynamic changes of patients during laparoscopic cholecystectomy surgery

نویسندگان [English]

  • Abbasali Dehghani 1
  • Vahid Fattahi 2
  • Vahideh Rahmani 3
  • Ali Sharifi 4
1 Associate Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Assistant Professor, Department of anesthesiology, Faculty of medicine, Tabriz University of Medical Sciences, Islamic Azad University, Tabriz, Iran.
3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Assistant Professor, Department of general surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: There are contradictory results regarding the effects of the menstrual cycle on changes in blood pressure, heart rate, ventilation, and oxytocin hormone during anesthesia in patients who are candidates for laparoscopic cholecystectomy surgery. Therefore, the present study was performed with aim to investigate the effect of menstrual phases on the hemodynamic changes of patients during laparoscopic cholecystectomy.
Methods: This cross-sectional descriptive study was conducted in 2018 on 100 patients who were candidates for laparoscopic cholecystectomy referred to Imam Reza Hospital (affiliated to Tabriz University of Medical Sciences). Patients were divided into two groups: luteal phase and follicular phase. Hemodynamic parameters, including heart rate, blood pressure, arterial oxygen saturation, and end-expiratory CO2 were compared between these groups. Demographic information and hemodynamic status before and during anesthesia were recorded in a researcher-made checklist. Data analysis was performed using SPSS software (version 22) and t-test, chi-square, and repeated measures tests. P<0.05 was considered statistically significant.
Results: According to the results of t-test, there was no statistically significant difference between the two groups at any time in the mean arterial pressure, end-expiratory CO2, and arterial oxygen saturation (P>0.05). However, according to the results of repeated measures tests, the mean arterial pressure changes during the study were significantly higher in the follicular phase group (P=0.031) than in the luteal phase group (P=0.059). Also, according to the results of t-test, the comparison of the heart rate status between the two groups did not show a significant statistical difference at any time (P˃0.05); However, according to the results of repeated measures tests, heart rate changes during the study were significantly higher in the follicular phase group (P=0.019) than in the luteal phase group (P=0.126).
Conclusion: Menstrual cycle significantly affects hemodynamic parameters during anesthesia in patients undergoing laparoscopic cholecystectomy. These changes are more pronounced during the follicular phase compared to the luteal phase.

کلیدواژه‌ها [English]

  • Blood pressure
  • Heart rate
  • Hemodynamic changes
  • Laparoscopic cholecystectomy
  • Menstruation

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 2
اردیبهشت 1403
صفحه 17-26

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