腹腔镜手术中不同二氧化碳气腹时间对患者肾功能的影响

Effect of Carbon Dioxide Pneumoperitoneum with Different Duration on Renal Function in Laparoscopic Operations

目的:了解不同的二氧化碳(CO2)气腹时间对患者肾功能的影响。方法:选取60例行腹腔镜手术的患者,按手术时间分成3组,T1组(<1 h)、T2组(1～2 h),T3组(>2 h),分别于术前,术后10 min、1 h、24 h检测血肌酐、尿肌酐和尿微量白蛋白。结果:T1组和T2组术后内生肌酐清除率(Ccr)较术前无显著差异;T3组术后10 min Ccr较术前显著降低,并且低于T1组和T2组,差异有统计学意义,但在术后1 h起逐渐升高。3组尿微量白蛋白/尿肌酐比值在术后均较术前显著升高,差异有统计学意义,但术后3组之间无显著差异。结论:长时间的CO2气腹可对肾功能产生显著急性影响,但在较短的时间内肾功能可逐渐恢复。

Objective： To explore the effect of carbon dioxide（CO2 ） pneumoperitoneum with different duration on renal function in laparoscopie operations. Methods：Sixty patients undergoing laparoscopic operations were divided into 3 groups according to the operative time： Group T1（〈1 h）, Group T2（1-2 h）, Group T3 （〈2 h）. Serum creatinine,urinary creatinine, urinary mieroalbumin were detected preoperatively, as well as 10 minutes,1 hour, 24 hours postoperatively. Results： The endogenous creatinine clearance rate （Ccr） postoperatively had no significant difference compared with preoperatively in group TI and T2; the Cer at 10 minutes postoperatively in group T3 was lower than preoperatively, and it was lower than those in group T1 and T2. The ratio of urinary microaibumin to urinary creatinine increased at postoperation than at preoperation in all 3 groups, but there was no significant difference among them. Conclusion： There was acute and significant change in renal function after a long duration of CO2 pneumoperitoneum, but renal function recovered gradually in a short time.