免气腹非全身麻醉后腹腔镜下肾囊肿去顶术  

Gasless retroperitoneal laparoscopic unroofing of renal cysts under non-general anesthesia

作　　者：瞿兆奎[1] 祁薇[1] 杨岗林 吉剑波[1] 吴大庆[1] 许少波[1] 

机构地区：[1]江苏省盐城市第三人民医院泌尿外科,江苏盐城224001

出　　处：《中国内镜杂志》2011年第12期1302-1304,1307,共4页China Journal of Endoscopy

摘　　要：目的探讨在免气腹非全麻后腹腔镜下行肾囊肿去顶减压术的可行性。方法 86例均来自该院2006年6月～2010年8月住院患者,被随机分为实验组与对照组,两组在性别、年龄等方面差异无显著性(P>0.05)。实验组41例用可折叠软柄撑开器行免气腹非全麻后腹腔镜手术。同期对照组45例开展普通后腹腔镜手术。每例手术患者均记录手术时间、术中出血量、术中术后高碳酸血症和恶心呕吐并发症的发生。结果两组手术均获成功,手术时间、术中出血量差异均无显著性(P>0.05);但实验组与对照组相比显著减少了手术时气腹、全麻可能引起的高碳酸血症和恶心呕吐并发症(P<0.05)。结论借助可折叠软柄撑开器开展免气腹非全麻后腹腔镜手术与普通后腹腔镜手术相比同样微创,患者痛苦小、恢复快、易于接受。且显著减少了原后腹腔镜手术时气腹、全麻可能引起的高碳酸血症和恶心呕吐并发症。Objective To discuss the feasibility of the gasless retroperitoneal laparoscopic unroofing of renal cysts under non-general anesthesia.Methods All 86 inpatients of the department from June 2006 to August 2010 were randomly divided into experimental group and control group,in which there were no significant gender and age differences （P0.05）.41 cases of experiment group were treated by gasless non-general anesthesia retroperitoneal laparoscopy using the collapsible distraction device with soft-handle.During the same period 45 cases of control group were treated by traditional retroperitoneal laparoscopy.The medical data of all the patients including operation time,amount of blood loss and complications such as hypercapnia,nausea and vomiting were recorded.Results Both the two groups had been operated successfully.There were no significant differences in operation time and blood loss （P0.05）,but the occurrence of possible complications such as hypercapnia,nausea and vomiting caused by pneumoperitoneum and general anesthesia had been declined significantly in experiment group compared with that in control group （P0.05）.Conclusion The gasless retroperitoneal laparoscopy under non-general anesthesia by using the collapsible distraction device with soft-handle is minimally invasive as traditional retroperitoneal laparoscopy.Patients are willing to accept it for its advantages of less pain and rapid recovery.At the same time the possible complications including hypercapnia,nausea and vomiting caused by pneumoperitoneum or general anesthesia can be declined significantly.

关 键 词：肾囊肿去顶术 免气腹腹腔镜 非全麻 可折叠软柄撑开器 

分 类 号：R692.9[医药卫生—泌尿科学] R699.2[医药卫生—外科学]