不同CO_2气腹压对老年结直肠癌腹腔镜手术患者下肢静脉回流的影响  

Effects of different CO_2 pneumoperitoneum pressures on lower extremity venous reflux in elderly patients with colorectal cancer undergoing laparoscopic surgery

作　　者：王坤[1] 张新伟[1] 王培民[1] 

机构地区：[1]河南省新乡市第一人民医院普外科,新乡453000

出　　处：《右江医学》2017年第4期468-470,共3页Chinese Youjiang Medical Journal

摘　　要：目的探讨不同CO_2气腹压对腹腔镜老年结直肠癌手术患者下肢静脉回流的影响,为老年结直肠癌腹腔镜手术患者的治疗提供参考。方法收集老年结直肠癌腹腔镜手术患者63例,根据不同气腹压将患者分为:低气腹压组(8 mm Hg CO_2)20例、中气腹压组(12 mm Hg CO_2)24例、高气腹压组(16 mm Hg CO_2)19例。比较各组气腹建立前(T1)、气腹设定压力14 mm Hg并维持20分钟时(T2)、气腹消除后20分钟时(T3)的股静脉直径、血管血流、血流量及术后下肢静脉血栓形成情况。结果 T2时,中气腹压组、高气腹压组股静脉直径较低气腹压组增大,血流速度、血流量较低气腹压组降低(P<0.05);高气腹压组股静脉直径较中气腹压组增大,血流速度、血流量较中气腹压组降低(P<0.05)。T3时,高气腹压组股静脉直径较低气腹压组、中气腹压组增大,血流速度、血流量较低气腹压组、中气腹压组降低(P<0.05)。结论在确保手术术野清晰,不影响手术操作的情况下,尽可能降低CO_2气腹压,而维持气腹压在12 mm Hg较为合适。Objective To investigate the effects of different CO2 pneumoperitoneum pressures on lower extremity venous reflux in elderly patients with colorectal cancer undergoing laparoscopic surgery,so as to provide reference for treating elderly patients with colorectal cancer.Methods 63 elderly patients with laparoscopic surgery for colorectal cancer were collected, according to different pneumoperitoneum pressures,they were divided into low pneumoperitoneum pressure group（8 mmHg CO2 ） （ n = 20） ,middle pneumoperitoneum pressure group（12 mmHg CO2 ） （ n = 24） and high pneumoperitoneum pressure group（16 mmHg CO2 ）（ n =19）.Femoral venous diameter, vascular blood flow and blood flow volume at T1（before establish-ment of pneumoperitoneum）, T2（setting of pneumoperitoneum pressure of 14 mmHg and maintaining for 20 minutes）and T3 （20 minutes after elimination of pneumoperitoneum）and postoperative lower extremity venous thrombosis were compared be-tween the two groups.Results At T2 , the femoral venous diameters in the middle pneumoperitoneum pressure group and the high pneumoperitoneum pressure group were significantly larger than that in the lower pneumoperitoneum pressure group, while the blood flow velocity and blood flow volume were significantly lower than those in lower pneumoperitoneum pressure group（P〈0.05） ; the femoral venous diameter in the high pneumoperitoneum pressure group was significantly larger than that in the middle pneumoperitoneum pressure group, and the blood flow velocity and blood flow volume were significantly lower（P 〈0.05）.At T3 , the femoral venous diameter in the high pneumoperitoneum pressure group was significantly larger than those in low pneumoperitoneum pressure group and middle pneumoperitoneum pressure group,and the blood flow velocity and blood flow volume were significantly lower than those in the low pneumoperitoneum pressure group

关 键 词：CO2气腹压 腹腔镜 结直肠癌 

分 类 号：R735.34[医药卫生—肿瘤]