低压力CO^2气腹在后腹腔镜手术中对机体功能的影响

Changes of body function in the patients undergone laparoscopic operation in response to low pneumoperitoneum pressure

目的探讨低压力(10 mmHg)CO2气腹在后腹腔镜手术中的应用价值。方法 64例后腹腔镜手术患者术前随机分为两组,术中气腹压力分别设定为10 mmHg(低压力组)和15 mmHg(标准压力组),测定两组患者气腹前后不同时段动脉血气,肝、肾功能;观察手术时间、术中出血量、术后肩部及上腹部疼痛的发生率等指标。结果低压力CO2气腹较常规压力CO2气腹对患者PaCO2、PH的影响小,术后肩部及上腹部疼痛的发生率低;对肝、肾功能、手术时间及术中出血量无明显影响。结论低压力CO2气腹对患者肝肾功能影响较小,能降低术后疼痛发生率,在后腹腔镜手术中有一定的应用价值。

Objective： To investigate the value of low pneumoperitoneum pressure in the retroperitoneum laparoscopic operation.Methods： A total of 64 patients treated with laparoscopic were divided into two groups,low pneumoperitoneum pressure group（l0mmHg） and standard pneumo-peritoneum pressure group（15mmHg）.The blood gas analysis,hepatic and renal function at different times were detected;the operating time,bleeding volum and postoperative pain were observed.Results： Low pneumoperitoneum pressure was significantly advantageous in terms of patients＇ PaCO2,PH and postoperative pain,there was no different effect in terms of hepatic function,renal function,operating time and bleeding volum compared with standard pneumoperitoneum pressure.Conclusion： Low pneumoperitoneum pressure affects the hepatic and renal function less,and appears effective in decreasing pain after laparoscopic operation.The low pressure pneumoperitoneum can be established in the retroperitoneum laparoscopic operation.