妇科腹腔镜手术二氧化碳气体温度和湿度对术中和术后影响的Meta分析

Intraoperative and postoperative impact of CO_2 temperature and humidity to gynecologic laparoscopic surgery: a meta-analysis

目的将灌注的二氧化碳CO_2气体适度的加温和加湿,以评估其对妇科腹腔镜手术的影响。方法 Pubmed和万方等数据库中搜索跟妇科腹腔镜手术CO_2气腹温度湿度相关的关键字,分析术后疼痛、镇痛药物使用、患者核心温度、术中情况和住院时间等情况。结果搜索出114篇跟妇科腹腔镜手术CO_2气腹温度湿度相关的文献,经过筛选后共17篇纳入Meta分析中。分析结果显示,与标准室温干燥气体相比,加热和加湿CO_2气腹可减轻术后当天疼痛和防止术中低体温出现,在术后吗啡每日用量、术后身体核心温度、麻醉恢复时间、住院时间、内镜镜头起雾和手术时间等差异无统计学意义。结论加热加湿后的CO_2气腹只在术后当天疼痛和术中核心温度上获益。有关加热加湿CO_2气腹对妇科腹腔镜手术的实际影响需要更多的研究来证实。

Objective To evaluate the impact of warmed and humidified CO2on the gynecological laparoscopic operation.Methods We searched keywords related to gynecological laparoscopic and CO2pneumoperitoneum temperature and humidity on Pubmed and Wanfang database,then analyze the postoperative pain,analgesic consumption,core temperature,operation time,length of hospital stay.Results17publications included into the meta analysis after screening.Compared with the standard laparoscopy,warmed and humidified CO2can reduce postoperative pain and prevent intraoperative hypothermia.No significant difference in postoperative analgesic consumption,postoperative core temperature,duration of recovery and hospital stay,endoscope lens fog and operation time.Conclusions Only few beneficial effects on postoperative pain and core temperature have been identified in this meta-analysis,though more studies are probably needed to study the real impact of warmed and humidified CO2for laparoscopic procedures.