CO_2气腹腹腔镜胆囊切除术后肩部疼痛原因及治疗

The causes and treatments postoperative shoulder pain after laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum

451例腹腔镜胆囊切除术（LC）患者分为延长吸氧组（A组）、常规吸氧组（B组）、非消炎痛治疗组（C）组和消炎痛治疗组（D组）。研究了CO2气腹LC前列腺素（PG）变化和术后肩部疼痛关系。结果显示：A组术后肩部疼痛发生率明显低于B组，C组高于D组，疗效比较有显著差异（P＜0．01）。研究表明在高浓度CO2状态下，PGE2合成增加，消炎痛能有效阻止PGE2的生物合成，延长吸氧和口服消炎痛能显著改善术后肩部疼痛。

451 patients in laparoscopic cholecystectomy with carbon dioxide were divided in to prolong inhalation hale oxygen group (group A), routine inhalation oxygen group (group B), non-indomethacin group (group C) and indomethacin group (group D). The study findings showed that shoulder pain in group A was less than in group B,and shoulder pain in group C was more than in group D. The study indicated that prostaglandin E2 synthesis were increased under high concentration of carbon dioxide condition. Indomethacin can suppress prostaglandin E2 biological synthesis,prolong inhalation oxygen and indomethacin can administration of improve postoperative shoulder pain.