延长吸氧时间对改善二氧化碳气腹腹腔镜胆囊切除术后肩部疼痛效果的临床研究

Clinical Study of the Effect of Prolonging Oxygen Inhalation on Reliving Scapulodynia after Laparoscopic Cholecystectomy

目的：探讨延长吸氧时间对改善二氧化碳气腹腹腔镜胆囊切除术（LC）后肩部疼痛的效果。方法：176例LC患者,随机分为延长吸氧组（n=88）,常规吸氧组（n=88）,常规吸氧组施行LC后持续低流量（2 L/min）吸氧2 h,延长吸氧组施行LC后持续低流量（2 L/min）吸氧8～12 h。观察两组间LC术后肩部疼痛发生率和疼痛程度。结果：延长吸氧组肩部疼痛发生率明显降低（P=0.000）,术后肩部疼痛VAS评分显著降低（P=0.015）;血气分析指标的比较,延长吸氧组手术后PaCO2（P=0.037）,PaO2（P=0.029）,pH（P=0.041）等血气指标较常规吸氧组均有差异;手术后4 h PaCO2与相同时点VAS评分呈正相关性,相关系数0.611（P=0.009）。结论：延长吸氧时间能降低LC术后肩部疼痛的发生率,改善LC术后肩部疼痛程度。

Objective：To study the effect of prolonging oxygen inhalation on reliving scapulodynia after laparoscopic cholecystectomy.Methods：One hundred and seventy-six patients and admitted and divided into two groups：prolonging oxygen group（n=88）,routinely oxygenic inhalation group（n=88）,their scapulodynia and the blood-gas analysis index（BGAI）were analyzed.Results：The incidence of scapulodynia after LC in prolonging oxygen inhalation group was significantly lower than that of routinely oxygen inhalation group（P=0.000）and the degree of scapulodynia in prolonging oxygen inhalation group was lower than that of routinely oxygen inhalation group（P=0.015）.PaCO2（P=0.037）in prolonging oxygen inhalation group was milder than that of routinely oxygen inhalation group,while PaO2（P=0.029）and PH（P=0.041）were higher.PaCO2 on 4 hours after operation had positive correlation with VAS on same time（r=0.611;P=0.009）.Conclusion：Prolonging oxygen inhalation could relief scapulodynia after laparoscopic cholecystectomy.