免气腹与气腹腹腔镜胆囊切除术的临床对比分析  

Comparative study of gasless and pneumoperitoneum laparoscopic cholecystectomy

作　　者：皮尔地瓦斯 克力木[1] 张成[1] 居来提[1] 李英[1] 

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《腹腔镜外科杂志》2014年第10期775-780,共6页Journal of Laparoscopic Surgery

基　　金：乌鲁木齐市科学技术计划项目(编号:G111310002)

摘　　要：目的:探讨免气腹腹腔镜胆囊切除术(gasless laparoscopic cholecystectomy,GLLC)的应用、优点及可行性。方法:选取2009年3月至2012年6月60例GLLC(免气腹组)及60例气腹腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC,气腹组)患者进行回顾性对比分析,对比两组手术时间、术中出血量、术后肠道功能恢复时间、住院时间、术前与术后血气分析、术后并发症等指标。结果:两组均成功完成手术,无一例中转开腹,切口均甲级愈合。两组患者手术时间、术中出血量、肛门排气时间、住院时间差异均无统计学意义(P>0.05)。术前DBP、PaO2、PaCO2、SpO2、PETCO2、pH两组相比差异均无统计学意义(P>0.05),术前SBP、MAP两组相比差异有统计学意义(P<0.05)。两组患者术后PaCO2、SpO2、pH值差异均无统计学意义(P>0.05),DBP、SBP、MAP、PaO2、PETCO2差异有统计学意义(P<0.05)。结论:免气腹腹腔镜手术具有安全、微创、术后康复快等优点,无CO2气腹相关并发症发生,对人体血流动力影响小,具有较好的临床应用价值。Objective： To study the applications,advantages and feasibility of the gasless laparoscopic cholecystectomy（ GLLC）. Methods：Clinical data of GLLC group（ n =60） and laparoscopic cholecystectomy group（ n =60） were collected from Mar.2009 to Jun. 2012. The mean operation time,the mean intraoperative blood loss,the postoperative intestinal function recovery time,the hospital stay,the preoperative and postoperative blood gas analysis and the postoperative complications were analyzed and compared between two groups. Results： All operations were successfully completed in both groups without conversion to laparotomy. All incisions were class-A healing. There were no statistical differences in operation time,the intraoperative blood loss,the postoperative intestinal function recovery time,the hospital stay,preoperative DBP,PaO2,PaCO2,SpO2,PETCO2 and pH value between two groups（ P〉 0. 05）.There were significant differences in preoperative SBP and MAP between two groups（ P〈 0. 05）. Postoperative PaCO2,SpO2 and pH value were not statistically different between two groups（ P〉 0. 05）. Postoperative DBP,SBP,MAP,PaCO2 and PETCO2were significantly different between two groups（ P〈 0. 05）. Conclusions： GLLC is a safe surgery with minimal invasion,quick postoperative recovery and there are no complications of CO2 pneumoperitoneum. GLLC has minimal hemodynamic effect to human body,and great value in clinical applications.

关 键 词：胆囊切除术 腹腔镜 免气腹 气腹 疗效比较研究 

分 类 号：R657.4[医药卫生—外科学]