不同压力CO_2气腹对机器人辅助腹腔镜前列腺癌根治术后患者膈下疼痛的影响

Effect of Different Carbon Dioxide Pneumoperitoneum on Subphrenic Pain in Patients after Robot-assisted Radical Prostatectomy

目的探讨不同压力CO_2气腹对机器人辅助腹腔镜前列腺癌根治术患者膈下疼痛的影响。方法选取机器人辅助腹腔镜前列腺癌根治术患者共150例,将其随机分为CO_2气腹压10 mm Hg、12 mm Hg、14 mm Hg 3组。采用视觉模拟评分法观察3组患者术后12 h、24 h和48 h膈下疼痛程度;记录术后膈下疼痛开始时间、膈下疼痛发生率及止痛药使用率。结果随CO_2气腹压升高,10 mm Hg组12 h、24 h和48 h膈下疼痛评分值显著下降,差异有统计学意义(P均<0.05);较之12 mm Hg组和14 mm Hg组,10mm Hg组在术后膈下疼痛开始时间、膈下疼痛发生率和止痛药使用率方面差异均有统计学意义(均P<0.05)。结论10 mm Hg的CO_2气腹压,机器人辅助腹腔镜前列腺癌根治术术后膈下疼痛程度和膈下疼痛的发生率最低,为围术期护理提供了新启示。

Objective To evaluate the effect of different carbon dioxide（CO2） pneumoperitoneum on subphrenic pain in patients after robot-assisted radical prostatectomy（RARP）. Methods A total of 150 patients after RARP were randomized into group A, B and C. Pneumoperitoneum was established respectively at 10 mm Hg（group A）, 12 mm Hg（group B） and 14 mm Hg（group C）.Subphrenic pain was recorded with a visual analogue pain scale 12 h, 24 h and 48 h after RARP respectively. The initiation time,incidences of the subphrenic pain and incidence of taking acesodyne were observed after operation. Results The scores of visual analogue scale（VAS） 12 h, 24 h and 48 h after RARP in group A were significantly lower than those in group B and C（all P〈0.05）.The initiation time and incidences of the subphrenic pain and taking acesodyne were statistically different in three groups（ P〈0.05）.Conclusion The 10 mm Hg CO2 pneumoperitoneum helps to improve subphrenic pain and reduce the occurrence of subphrenic pain of patients with RARP.