不同CO_2气腹压力对腹腔镜直肠癌手术患者恢复的影响  

Effect of different CO_2 pneumoperitoneum pressure on the recovery of patients undergoing laparoscopic surgery for rectal cancer

作　　者：贾占辉[1] 励秀武[1] 罗新书[1] 冉战玲[2] JIA Zhan-hui;LI Xiu-wu;LUO Xin-shu;RAN Zhan-ling

机构地区：[1]河北医科大学第二医院,石家庄市050000 [2]河北省人民医院

出　　处：《护理实践与研究》2018年第13期115-117,共3页Nursing Practice and Research

基　　金：河北省医学科学重点研究项目(20150680);河北医科大学第二医院院级课题项目(2h1201524)

摘　　要：目的探讨不同CO_2气腹压力对腹腔镜直肠癌手术后患者恢复的影响。方法抽取90例直肠癌手术患者,随机等分为三组,即低气腹压力组(LP组),气腹压力维持在8~10 mmHg(1 mm Hg=0.133 kPa);中气腹压力组(MP组),气腹压力维持在11~13 mmHg;高气腹压力组(HP组),气腹压力维持在14~16 mmHg;比较三种不同气腹压力组患者术后30 min平均动脉压(MAP)、心率(HR)、和血氧饱和度(SpO_2)差异以及术后肠鸣音首次出现时间,肛门排气时间及术后进食时间。结果 HP组患者术后30 min MAP、HR、较其他两组高,SpO_2较其他两组低;肠鸣音首次出现时间,肛门排气时间及术后进食时间都较其余两组患者时间长。结论对腹腔镜直肠癌手术患者,在充分保证手术顺利进行的条件下,气腹压力维持在8~13 mmHg之间时,患者的血流动力学等参数影响较小,患者苏醒速度快;同时可有效促进患者术后胃肠功能的的恢复。Objective To explore the effect of different CO_2 pneumoperitoneum pressure on the recovery of patients undergoing laparoscopic surgery for rectal cancer. Methods To select 90 cases of patients with rectal cancer as subjects,and they were divided into three groups randomly： low pneumoperitoneum pressure group（ LP group） whose pneumoperitoneum pressure maintained at 8-10 mm Hg（ 1 mmHg = 0. 133 kPa）,pneumoperitoneum pressure group（ MP group） whose pneumoperitoneum pressure maintained at 11-13 mmHg,as well as high pneumoperitoneum pressure group（ HP group） whose pneumoperitoneum pressure maintained at 14-16 mmHg. The mean arterial pressure（ MAP）,heart rate（ HR）,and differences in blood oxygen saturation（ SpO_2） at 30 minutes after surgery,the first appearance of intestinal tinnitus after the surgery,anus exhausting time,and postoperative feeding time in three different pneumoperitoneum pressure groups were compared. Results MAP and HR in the HP group were significantly higher than that in the other two groups at 30 minutes after operation,and SpO_2 was lower than that in the other two groups. The first occurrence of bowel sounds,anus exhaust time,and postoperative feeding time were longer than those in the other two groups. Conclusion For patients undergoing laparoscopic surgery for rectal cancer,under the conditions that ensure the successful operation,the hemodynamic parameters of the patient has less effect if the pneumoperitoneum pressure is maintained between 8-13 mmHg. Under this condition,the patients wake up faster. At the same time,it can effectively promote the recovery of postoperative gastrointestinal function.

关 键 词：腹腔镜 气腹压力 直肠癌手术 胃肠功能 恢复 

分 类 号：R473.73[医药卫生—护理学]