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目的:探讨改良“Z字形”屈氏位对腹腔镜子宫内膜癌根治术患者血流动力学的影响,为患者手术体位的选择提供参考。方法:选取2017年4月至2019年4月在湖北省襄阳市中心医院行腹腔镜子宫内膜癌根治术的患者80例,按照随机数字表法分为试验组和对照组,每组40例。对照组采用常规头低足高截石位,试验组采用改良“Z字形”屈氏位。分别记录2组患者气腹前10 min(Tn 0)、气腹即刻(Tn 1)、气腹后5 min(Tn 2)、气腹后10 min(Tn 3)、气腹后30 min(Tn 4)、气腹后60 min(Tn 5)、恢复水平体位后1 min(Tn 6)的心率、平均动脉压、中心静脉压、体循环阻力和心排出量,并于术后24 h对患者进行随访,采用视觉模拟量表(VAS)评价肩部和下肢疼痛程度。n 结果:Tn 0~Tn 6时,2组患者心率、平均动脉压、体循环阻力和心排出量差异无统计学意义(均n P>0.05)。Tn 2~Tn 6的每个时间点试验组的中心静脉压分别为(9.86 ± 1.95)、(10.94 ± 1.53)、(11.33 ± 2.24)、(11.14 ± 1.54)、(7.75 ± 1.59)cmHn 2O(1 cmHn 2O=0.098 kPa),均低于对照组的(18.83 ± 2.82)、(16.81 ± 2.93)、(16.27 ± 3.56)、(15.76 ± 2.33)、(8.92 ± 1.68)cmHn 2O,差异有统计学意义(n t值为3.057~15.736,均n P<0.05)。试验组肩部疼痛和下肢疼痛VAS评分分别为(3.48 ± 1.10)、(2.35 ± 0.66)分,低于对照组的(4.16 ± 1.32)、(2.99 ± 1.02)分,差异有统计学意义(n t值为2.404、3.228,n P0.05). The central venous pressure were (9.86±1.95), (10.94±1.53), (11.33±2.24), (11.14±1.54),(7.75±1.59) cmHn 2O(1 cmHn 2O=0.098 kPa) respectively from Tn 2 to Tn 6 in the experiment group, lower than that of control group (18.83±2.82), (16.81±2.93), (16.27±3.56), (15.76±2.33), (8.92±1.68) cmHn 2O at the same time, the differences were statically significant (n t values were 3.057-15.736, all n P<0.05). The VAS scores of shoulder pain and low leg pain in experiment group were (3.48±1.10), (2.35±0.66) points, lower than that of control group (4.16±1.32), (2.99±1.02) points, the differences were statically significant (n t values were 2.404, 3.228, n P<0.05).n Conclusions:Modified Z Trendelenburg position can maintain the circulatory system hemodynamic stability, reduce the degree of shoulder pain and low leg pain after surgery in the laparoscopic radical resection for endometrial carcinoma patients.