经腹入路腹腔镜肾上腺手术的体位探讨

Approach on Postures of Patients Undergoing Laparoscopic Suprarenal Surgery via Transabdominal Inlet

目的 :探讨经腹入路腹镜肾上腺手术体位的可行性。方法 :选择经腹入路腹腔镜肾上腺手术病人 5 6例 ,其中 3 0例术中采用 70度健侧斜卧位 (治疗组 ) ,2 6例术侧躯干抬高约 3 0度 ,观察两组病人手术时间、术中出血量以及术中、术后并发症等指标。结果 :治疗组手术时间、进食时间、住院时间明显短于对照组 (P <0 .0 1) ,术中出血量也明显减少 (P <0 .0 1) ,且术中、术后并发症发生率有统计学意义 (P <0 .0 1)。结论 :经腹入路腹腔镜肾上腺手术采用 70度健侧斜卧位 ,能减轻手术对肠道的刺激 。

Objective: to explore the feasibility on the posture patients should take when they were undergoing laparoscopic suprarenal surgery via transabdominal inlet. Methods: a total of 56 cases were selected. 30 cases of them in test group took 70 degrees of healthy lateral recumbent position. 26 cases of them in control group took the position that operative side of the trunk of patients lifted up 30 degrees. Indexes including operation time, amounts of hemorrhage, and postoperative complications of patients in both groups were observed. Results: patients of the test group had shorter operation time, food-intake time, and hospitalization time than patients of control group had (all P<0.01). Patients of test group had less amounts of hemorrhage during the operation than patients of control group had (P<0.01). There was statistical significance between patients of the two groups in terms of operative and postoperative complications (P<0.01). Conclusion: to take 70 degrees of healthy lateral recumbent position could mitigate the stimulation of the operation itself on intestinal tract. It is also beneficial to the early stage recovery of patients.