术中气腹压对直肠癌微创手术后患者消化系统的影响分析  

Analysis of the influence of intraoperative pneumoperitoneum pressure on the digestive system of patients after minimally invasive surgery for rectal cancer

作　　者：高山 何若冰[1] 孙承宇[1] GAO Shan;HE Ruobing;SUN Chengyu(Department of General Surgery,Shenyang Anorectal Hospital,Shenyang,Liaoning,110002,China)

机构地区：[1]沈阳市肛肠医院普外科,辽宁沈阳110002

出　　处：《当代医学》2021年第3期11-13,共3页Contemporary Medicine

摘　　要：目的分析术中气腹压对直肠癌微创手术后患者消化系统的影响。方法选取2017年2月至2019年5月本院收治的80例腹腔镜直肠癌根治术患者,根据术中气腹压力分为低压力组(8~11 mmHg)和高压力组(12~15 mmHg),每组40例。观察比较两组患者术中、术后指标及并发症发生率。结果两组患者淋巴结清扫数量、术中出血量、手术时间比较差异无统计学意义;低压力组禁食时间、排气时间、肠鸣音恢复时间、住院时间均低于高压力组,差异具有统计学意义(P<0.05);低压力组术后并发症(腹泻、下肢深静脉血栓、恶心呕吐、肠麻痹)发生率低于高压力组,差异具有统计学意义(P<0.05)。结论直肠癌微创手术中气腹压过高会损伤患者肠黏膜,影响患者术后肠道功能恢复,因此,在确保手术视野清晰条件下,应尽量降低术中气腹压力,以促进患者术后肠道功能恢复。Objective To analyze the effect of intraoperative pneumoperitoneum pressure on the digestive system of patients after minimally invasive surgery for rectal cancer.Methods 80 patients with laparoscopic radical resection of rectal cancer admitted to our hospital from February 2017 to May 2019 were selected.According to the intraoperative pneumoperoneum pressure,they were divided into the low pressure group(8-11 mmHg)and the high pressure group(12-15 mmHg),with 40 cases in each group.Observe and compare the intraoperative and postoperative indicators and the incidence of complications between the two groups.Results There was no significant difference in the number of lymph node dissection,intraoperative blood loss and operation time between the two groups.The fasting time,exhaust time,bowel sound recovery time and hospitalization time in the low pressure group were lower than those in the high pressure group,with statistically significant difference(P<0.05).The incidence of postoperative complications(diarrhea,lower limb deep vein thrombosis,nausea and vomiting,and intestinal paralysis)was lower in the low pressure group than in the high pressure group, with statistically significant differences (P<0.05). Conclusion High pneumoperitoneum pressure in minimallyinvasive surgery for rectal cancer can damage patients' intestinal mucosa and affect postoperative recovery of intestinal function. Therefore,under the condition of ensuring clear surgical field of vision, intraoperative pneumoperitoneum pressure should be minimized to promote postoperativerecovery of intestinal function of patients.

关 键 词：术中气腹压 直肠癌 微创手术 消化系统 肠胃功能 

分 类 号：R735.37[医药卫生—肿瘤]