气腹压力对腹腔镜直肠癌根治术患者全麻苏醒质量的影响  

Effect of pneumoperitoneum pressure on revival quality of general anesthesia patients with radical resection of colorectal cancer through laparoscope

作　　者：孟国芳[1] 陈英[1] 何飞燕[1] 孙红华[1] 

机构地区：[1]浙江省绍兴市人民医院浙江大学绍兴医院手术室,312000

出　　处：《中华现代护理杂志》2013年第31期3879-3881,共3页Chinese Journal of Modern Nursing

摘　　要：目的 观察不同气腹压力对腹腔镜直肠癌根治术患者全麻苏醒质量的影响.方法 将ASA Ⅰ ～Ⅱ级择期全麻下行腹腔镜直肠癌根治术患者60例,随机分为低压力组和高压力组两组.两组患者均在气管内插管静吸复合麻醉下手术,术毕使用静脉镇痛泵镇痛.低压力组采用10 mm Hg气腹压力,高压力组采用14 mm Hg气腹压力.比较两组气腹时间、手术时间、苏醒时间、拔管时间、术中高PETCO2发生率、苏醒期躁动及心血管用药等情况.结果 低压力组气腹时间、手术时间分别为（160 ±24）,（185±35） min,高压力组分别为（152±22）,（174±32） min,两组比较差异均无统计学意义（t值分别为1.652,1.661;P ＞0.05）.低压力组苏醒时间、拨管时间分别为（28 ±11）,（35±15） min,高压力组分别为（41±18）,（50±20） min,两组比较差异均有统计学意义（t值分别为2.395,2.672;P＜0.05）.低压力组术中高PETCO2发生率、苏醒期躁动发生率及心血管用药率分别为33.3％,16.7％,40.0％,高压力组分别为63.3％,46.7％,70.0％,两组比较差异均有统计学意义（x2值分别为5.41,6.24,5.45;P＜ 0.05）.结论 气腹压力可影响腹腔镜直肠癌手术患者全麻的苏醒质量,低压力使患者苏醒更安全、舒适.Objective To observe the effect of different pneumoperitoneum pressure on revival quality of patients with radical resection of eoloreetal cancer through laparoseope. Methods Sixty ASA I - lI patients with selective radical resection of eoloreetal cancer through laparoseope under general anesthesia were divided into low pressure group （group L） and high pressure group （group H）. 3.11 patients were operated in general anesthesia by tracheal intubations, and the intravenous analgesia pump was used to analgesia after operation. 10 mm Hg pneumoperitoneum pressure was adopted in Group L and 14 mm Hg in Group H. The time of pneumoperitoneum, operation time, revival time, extuhation time, the incidence rate of high PET CO2 in operation, the impetuousness in revival and the condition of administering cardiovascular drugs in two groups were compared. Results The time of pneumoperitoneum and operation in Group L was respectively （ 160 ± 24）rain, （185 ±35） min, and respectively （152 ±22） min, （174 ±32） min in Group H, and the differences were not statistically significant （t = 1. 652,1. 661, respectively ;P 〉 0. 05 ）. The time of revival and extuhation in Group L was respectively （28 ± 11 ） min, （ 35 ± 15 ） min, and respectively （41 ± 18 ） rain, （50 ± 20） min in Group H, and the differences were statistically significant （t =2. 395,2. 672, respeetively;P 〈0. 05）. Therate of high PEr CO2 in operation, the rate of impetuousness in revival and the condition of administering cardiovascular drugs in Group L were respectively 33.3%, 16. 7% ,40. 0%, which were significantly lower than 63.3% ,46.7% ,70. 0% in Group H, and the differences were statistically significant （X2 =5.41,6.24,5.45, respectively;P 〈 0. 05）. Conclusions Pneumoperitoneum pressure can influence the revival quality of patients in radical resection of colorectal cancer through laparoscope, and low pressure makes the patient safer and more comfortable.

关 键 词：气腹 人工 压力 结直肠肿瘤 麻醉后护理 苏醒质量 

分 类 号：R473.73[医药卫生—护理学]