不同气腹压力下腹腔镜胆囊切除术气腹并发症的比较研究  

Pneumoperitoneum-related complications following laparoscopic cholecystectomy at different pressures: A comparison study

作　　者：张景华[1] 曹月敏[1] 谭文科[1] 江建军[1] 张万星[1] 王兰辉[1] 

机构地区：[1]河北省人民医院普外三科

出　　处：《中国微创外科杂志》2005年第2期136-137,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨腹腔镜胆囊切除术 (laparoscopic cholecystectomy,LC)气腹并发症的防治。　方法　回顾分析 1993年 10月至 2003年 1月 1 100例LC的临床资料, 2001年 9月前入院的 980例为A组,气腹压力设定 14mmHg, 2001年 9月以后的 120例为B组,气腹压力设定 10mmHg。　结果　B组无明显高碳酸血症发生,而A组有 2例发生;B组肩部疼痛发生率 19 2% (23 /120)明显低于A组 43. 9% (430 /980) (χ2 =26. 951,P=0 .000)。B组恶心呕吐发生率 25 .8% (31 /120)明显低于A组 61 .2% (600 /980) (χ2 =54 750,P=0 .000)。　结论　高碳酸血症、肩部疼痛及恶心、呕吐等气腹并发症可通过术中注意调节通气量,降低气腹压力等措施防治。Objective To study the prevention and treatment of pneumoperitoneum-related complications after laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 1 100 cases of LC from October 1993 to January 2003. The cases were divided into two groups: 980 cases admitted before September 2001 received a 14 mmHg carbon dioxide pneumoperitoneum (Group A), and 120 cases after September 2001 received a 10 mmHg pneumoperitoneum (Group B). Results Carbonemia happened in 2 cases in the Group A but in no cases in the Group B. The incidence of postoperative shoulder pain was significantly lower in the Group B (19 2%, 23/120) than in the Group A (43 9%, 430/980) ( χ 2 =26 951, P =0 000). The incidence of postoperative nausea and vomiting (PONV) was significantly lower in the Group B (25 8%, 31/120) than in the Group A (61 2%, 600/980) ( χ 2 =54 750, P =0 000). Conclusions Carbonemia, shoulder pain and PONV can be reduced by regulating the ventilation and decreasing the pneumoperitoneum pressure.

关 键 词：腹腔镜胆囊切除术 气腹 并发症 

分 类 号：R657.4[医药卫生—外科学]