不同二氧化碳(CO2)注入对老年患者腹腔镜结直肠癌手术的影响

Effect of Different Carbon Dioxide(CO2)Injection on Laparoscopic Colorectal Cancer Surgery in Elderly Patients

目的本研究旨在探讨使用湿润温热的二氧化碳(湿热CO2)对老年患者行腹腔镜结直肠癌手术的影响。方法在2017年3月至2018年3月收入我院行腹腔镜结直肠癌手术的老年患者共92例纳入本次研究。将其随机分为2组。所有患者均在全麻下行腹腔镜结直肠癌手术。在患者术中通入不同的CO2,观察患者的各项术中、术后指标变化和不良事件发生情况。结果对照组的舒芬太尼服用量显着高于实验组(P<0.05)。与对照组相比,实验组的患者术中体温降低、首次肠胃胀气时间、第一次固体食物摄入时间、住院时间和伤口恢复时间显著降低,对照组从气腹后60 min到气腹结束,血浆凝血酶原时间(PT),活化部分凝血活酶时间(APTT)和血浆凝血酶时间(TT)明显高于实验组(P<0.05)。结论术中用湿热CO2吹气有助于维持局部正常体温,减少凝血功能障碍、舒芬太尼服用量、第一次肠胃气、第一次固体食物摄入时间和住院时间,且有助于术后伤口愈合。具有很好的临床价值。

Objective The purpose of this study was to investigate the effect of the use of moist,warm and hot carbon dioxide(wet-hot CO2)on laparoscopic colorectal cancer surgery in elderly patients.Methods A total of 92 elderly patients receiving laparoscopic colorectal cancer surgery in our hospital from March 2017 to March 2018 were included in this study.They were randomly divided into two groups.All patients underwent laparoscopic colorectal cancer surgery under general anesthesia.Different CO2 was injected during the operation to observe the changes of intraoperative and postoperative indicators and the occurrence of adverse events.Results The dosage of sufentanil in the control group was significantly higher than that in the experimental group(P<0.05).Compared with control group,experimental group patients intraoperatie hypothermia,intestines and stomach bilge gas time for the first time,the first solid food intake time,hospitalization time and wound recovery time decreased significantly,the control from the 60 minutes after pneumoperitoneum pneumoperitoneum end,plasma prothrombin time(PT),activated partial thrombin time(APTT)live enzymes and plasma thrombin time(TT)was significantly higher than the experimental group(P<0.05).Conclusion Intraoperative hot and humid CO2 blowing is helpful to maintain local normal body temperature,reduce coagulation dysfunction,sufentanil dosage,first gastrointestinal gas,first solid food intake time and hospital stay,and help postoperative wound healing.It has good clinical value.