上尿路后腹腔镜手术中不同压力气腹对机体的影响

Influence of Carbon Dioxide Pneumoperitoneum with Different Insufflation Pressure on Patients Undergoing Retroperitoneum Laparoscopic Operation

目的探讨不同压力CO_2气腹在上尿路后腹腔镜手术中对患者机体的影响。方法将2011年09月至2013年12月间在本院行后腹腔镜肾上腺肿瘤切除术和后腹腔镜肾囊肿去顶减压术的68例患者术前随机分为两组,术中气腹压力分别设定为l0mmHg和15mmHg,测定两组气腹前、气腹后30分钟和放气后30分钟的动脉血气;观察手术时间、术中出血量;并记录术后疼痛等并发症的发生率。结果两组手术时间及术中出血量无明显差别;低压力气腹较常规压力气腹对患者PaCO_2、PH的影响更小,术后肩部及上腹部疼痛的发生率更低。结论低压力CO_2气腹相对于常规压力CO_2气腹对患者各系统功能影响较小,在后腹腔镜手术中有一定的应用价值。

Objective To explore the value of low CO2 insufflation pressure in the retroperitoneum laparo-scopic operation.Methods 68 cases treated with laparoscopic were divided into two groups, low pneumoperitone-um pressure group (10mmHg) and standard pneumoperitoneum pressure group (15mmHg).Arterial blood gas were measured at three points:time before CO2 insufflation, 30 minutes after insufflations, and 30 minutes after exsufflation.The operating time, blood loss and complications were observed.Results Compared to the standard pressure group, the low pressure group had lower complication occurrence and higher safety with statistic signifi-cance (P<0.05).The operating time and blood loss had no significant difference in the two groups.Conclu-sions The low pressure CO2 insufflation is valuable in the retroperitoneum laparoscopic operation.