[1]杨 勇,金 雷△.腹腔镜胆囊切除术中不同气腹压力与并发症的关系研究[J].陕西医学杂志,2019,(2):169-172.
　YANG Yong,JIN Lei..Relationship between different pneumoperitoneum pressure and complications in laparoscopic cholecystectomy[J].,2019,(2):169-172.
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腹腔镜胆囊切除术中不同气腹压力与并发症的关系研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年2期
页码:
169-172
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Relationship between different pneumoperitoneum pressure and complications in laparoscopic cholecystectomy
文章编号:
DOI: 10.3969/j.issn.10007377.2019.02.008
作者:
杨 勇; 金 雷△
西安市第九医院普外二科（西安 710054）
Author(s):
YANG Yong; JIN Lei.
Department of General Surgery, Ninth Hospital of Xi’an(Xi’an 710054)
关键词:
腹腔镜; 胆囊切除术; 气腹压力; 并发症; 呕吐; 肩胛区疼痛
Keywords:
Key words 〖JP2〗Laparoscopy;  Cholecystectomy;  Pneumoperitoneum pressure;  Complications; Vomit; Scapula pain
分类号:
R614.2
文献标志码:
A
摘要:
摘 要 目的：探究腹腔镜胆囊切除术中不同气腹压力与患者术后并发症发生率的相关性。方法：选择行腹腔镜胆囊切除术的128例患者为研究对象，按照随机数字表法将其均分为A、B两组，每组各64例患者，A组患者术中气腹压力为10 mmHg，B组为15 mmHg，对比两组患者术前及术后肝功能指标（ALT、AST、TBIL）、动脉血气指标（pH值、PCO2、PO2），对两组患者术后并发症诸如呕吐、肩胛区疼痛、心律失常的发生率进行对比。结果：①术前两组患者ALT、AST、TBIL水平对比差异不具有统计学意义（P>0.05），术后ALT水平、AST水平、TBIL水平B组>A组（P<0.05）；②术前两组患者pH值、PCO2、PO2值对比差异不具有统计学意义（P>0.05），术后B组PO2值低于A组（P<0.05），B组PCO2值高于A组，B组pH值低于A组，但差异无统计学意义（P>0.05）；③术后A组并发症发生率低于B组（P<0.05）。结论：不同气腹压力会对腹腔镜下胆囊切除术患者肝功能及血气指标产生不同的影响，高气腹压力会引发术后肝功能及动脉血气指标一过性改变，同时高气腹压力会增加患者术后并发症发生率，术中应结合实际尽量降低气腹压力。
Abstract:
Abstract 〖JP3〗Objective:To explore the correlation between different pneumoperitoneum pressure and the incidence of postoperative complications in laparoscopic cholecystectomy.Methods: 128 patients were divided into two groups according to random number table method. 64 patients in each group were divided into two groups. The intraoperative pneumoperitoneal pressure of group A was 10 mmHg and that of group B was 15 mmHg. The preoperative and postoperative liver function indexes (ALT and AST) of the two groups were compared. The incidence of postoperative complications such as vomiting, scapular pain and arrhythmia was compared between the two groups.Results:①There was no significant difference in ALT, AST and TBIL levels between the two groups before operation (P>0.05). After operation, ALT, AST and TBIL levels in group B were higher than those in group A (P<0.05);② There was no significant difference in pH, PCO2 and PO2 values between the two groups before operation (P>0.05), and PO2 values in group B were lower than those in group A (P<0.05). The PCO2 value in group B was higher than that in group A (P< 0.05), and the pH value in group B was lower than that in group A (P>0.05); ③The incidence of complications in group A was lower than that in group B (P<0.05).Conclusion: Different pneumoperitoneal pressures have different effects on liver function and blood gas index in patients undergoing laparoscopic cholecystectomy. High pneumoperitoneal pressure may cause transient changes in liver function and arterial blood gas index after cholecystectomy. High pneumoperitoneal pressure may increase the incidence of postoperative complications pneumoperitoneal pressure should be lowered as far as possible in combination with the actual situationpower.〖JP〗

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更新日期/Last Update: 2019-03-13