对比智能自适应手术牵张系统与二氧化碳气腹在实验小猪腹腔镜胆囊及阑尾切除术中的应用效果

Comparison of the application effect of intelligent adaptive surgical stretch system and carbon dioxide pneumoperitoneum in laparoscopic cholecystectomy and appendectomy in experimental piglets

目的探讨智能自适应手术牵张系统与二氧化碳(CO_(2))气腹在实验小猪腹腔镜胆囊及阑尾切除术中的应用价值。方法于动物实验中心购买20只健康巴马小型猪进行研究,根据配对比较法分成智能系统组与CO_(2)气腹组,每组各10只。比较两组术野满意度及手术空间暴露时间、手术时间、肚脐切口长度、切口愈合时间、术中出血量,记录术前(T_(0))及术中20 min(T_(1))、术中40 min(T_(2))、术中60 min(T_(3))的碳酸氢根离子(HCO_(3)^(-))、二氧化碳分压(PCO_(2))、酸碱度(pH)值变化。分别在术前、术后24 h,采血检测血清超敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,比较两组并发症发生率。结果两组术野优良率均为100%,组间比较差异无统计学意义(P>0.05)。两组手术空间暴露时间、手术时间、切口愈合时间、术中出血量比较,差异均无统计学意义(P>0.05),智能系统组肚脐切口长度长于CO_(2)气腹组,差异有统计学意义(P<0.05)。智能系统组T_(1)、T_(2)、T_(3)的HCO_(3)^(-)、PCO_(2)低于CO_(2)气腹组,pH值高于CO_(2)气腹组,差异均有统计学意义(P<0.05)。两组术后血清hs-CRP、IL-6、TNF-α水平均高于术前,差异均有统计学意义(P<0.05),但两组间血清hs-CRP、IL-6、TNF-α水平比较,差异均无统计学意义(P>0.05)。智能系统组并发症率为0,低于CO_(2)气腹组(50.00%),差异有统计学意义(P<0.05)。结论智能自适应手术牵张系统能提升实验小猪术中血气分析指标的稳定性,避免气腹并发症的发生,且术野满意度良好,不会影响术后恢复。

Objective To investigate the application value of intelligent adaptive surgical stretch system and carbon dioxide(CO_(2))pneumoperitoneum in laparoscopic cholecystectomy and appendectomy in experimental piglets.Methods Twenty healthy Bama miniature piglets were purchased from animal experimental center for study,and were divided into intelligent system group and CO_(2)pneumoperitoneum group with 10 piglets each according to paired comparison method.Surgical field satisfaction,surgical space exposure time,surgical time,navel incision length,incision healing time and intraoperative blood loss were compared between the two groups.Changes of bicarbonate ion(HCO_(3)^(-)),partial pressure of carbon dioxide(PCO_(2))and pH were recorded before(T_(0)),20 min(T_(1)),40 min(T_(2))and 60 min(T_(3))during surgery.The levels of serum hypersensitive C reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were collected before and 24 h after surgery,and the incidence of complications between the two groups were compared.Results The excellent and good rate of operation field in both groups was 100%,and there was no difference between the two groups(P>0.05).There were no differences in surgical space exposure time,operative time,incision healing time and intraoperative blood loss between the two groups(P>0.05).The length of navel incision in the intelligent system group was longer than that in the CO_(2)pneumoperitoneum group(P<0.05).The HCO_(3)^(-)and PCO_(2)of the intelligent system group T_(1),T_(2)and T_(3)were lower than those of the CO_(2)pneumoperitoneum group,and the pH value was higher than that of the CO_(2)pneumoperitoneum group,and the differences were statistically significant(P<0.05).The levels serum of hs-CRP,IL-6,and TNF-αin the two groups after surgery were higher than those before surgery,and the differences were statistically significant(P<0.05).However,there were no statistically significant differences in the levels of serum hs-CRP,IL-6,and TNF-αbetween the two groups(P>0.05).The complication rate of intelligent system group was 0,which was lower than that of CO_(2)pneumoperitoneum group(50.00%),and the difference was statistically significant(P<0.05).Conclusion The intelligent adaptive surgical stretch system can improve the stability of blood gas analysis index and avoid the occurrence of pneumoperitoneum complications in experimental piglets,and the satisfaction of the operative field is good,and will not affect the postoperative recovery.