免气腹悬吊式腹腔镜在卵巢良性肿瘤手术麻醉中的安全性研究  

Study of anesthetic safety in gasless laparascopic surgery for benign ovarian tumor

作　　者：高小云 高丽丽[1] 李银凤[1] GAO Xiao-yun;GAO Li-li;LI Yin-feng(Departemnt of Obstetrics and Gynecology,First Hospital of Hohhot,Hohhot 010000.China)

机构地区：[1]呼和浩特市第一医院妇产科,内蒙古呼和浩特市010000

出　　处：《中国实用妇科与产科杂志》2021年第2期241-244,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：呼和浩特市科技计划项目(2018-社-7-1)。

摘　　要：目的探讨免气腹腹腔镜卵巢囊肿手术麻醉中的安全性。方法研究对象为2019年7月至2020年6月呼和浩特市第一医院有手术指征的100例卵巢囊肿患者,随机分组为免气腹腹腔镜组(免气腹组)及CO2气腹腹腔镜组(气腹组),分别观察两组患者在术前(麻醉开始时)(T0)、术中40min(T1)、术后10min(T2)各时点最高气道内压(PAP)、呼气末CO2分压(PET-CO2)、动脉血CO2分压(PaCO2)、血pH值的变化,并比较两组上述指标的变化。同时观察两组患者术后并发症发生情况。结果免气腹组PAP在麻醉开始后T1、T2与T0比较,差异无统计学意义(P>0.05);气腹组PAP在麻醉开始后T1、T2与T0比较,均显著升高(P<0.05)。免气腹组与气腹组的T1、T2同时点比较,差异有统计学意义(P<0.05)。免气腹组PET-CO2、PaCO2在麻醉开始后T1、T2与T0比较,差异均无统计学意义(P>0.05);气腹组PET-CO2、PaCO2在麻醉开始后T1、T2与T0比较,均显著升高(P<0.05)。免气腹组与气腹组的PET-CO2、PaCO2在T1、T2同时点比较,差异有统计学意义(P<0.05)。免气腹组血pH值在麻醉开始后T1、T2与T0比较,差异无统计学意义;气腹组血pH值在麻醉开始后T1、T2与T0比较,差异有统计学意义(P<0.05)。免气腹组与气腹组血pH在T1、T2同时点比较,差异有统计学意义(P<0.05)。气腹组术后肩痛发生率显著高于免气腹组(P<0.05)。结论免气腹腹腔镜技术可避免气腹的相关并发症,对于患有呼吸、循环系统疾病和老年患者,免气腹腹腔镜技术能为患者提供了更好的选择。Objective To explore the safety of anesthesia during gasless laparoscopic surgery for ovarian cysts.Methods The subjects of the study were 100 patients with ovarian cysts treated in First Hospital of Hohhot from July2019 to June 2020,who had indications for operation.They were randomly divided into gasless laparoscopic group(gasless group) and CO2 pneumoperitoneum laparoscopic group(pneumoperitoneum group).Observe the preoperative(at the beginning of anesthesia)(T0),intraoperative 40 min(T1) and postoperative 10 min(T2) Changes in maximum airway pressure(PAP),end-expiratory CO2 partial pressure(PET-CO2),arterial blood CO2 partial pressure(PaCO2),and blood pH,and compare the changes of the above indicators between the two groups.At the same time observe the postoperative complications of the two groups of patients.Results PAP in the gasless group had no significant difference between T1 or T2 and T0 after the start of anesthesia(P> 0.05);PAP in the pneumoperitoneum group was significantly higher at T0 than at T1 and T2 after the start of anesthesia(P <0.05).There was a statistically significant difference at T1 and T2 between the gasless group and the pneumoperitoneum group(P <0.05).There was no significant difference in PET-CO2 and PaCO2 in the gasless group at T1 or T2 compared with T0 after the start of anesthesia(P> 0.05);PET-CO2 and PaCO2 in the pneumoperitoneum group were significantly increased at T1 and T2 compared with T0 after the start of anesthesia in comparison(P <0.05).Comparing PET-CO2 and PCO2 between the gasless group and the pneumoperitoneum group at the same point of T1 and T2,the difference was statistically significant(P <0.05).The blood pH value of the gasless group at T1 and T2 was compared with T0 after the start of anesthesia,and the difference was not statistically significant;the blood pH value of the pneumoperitoneum group at T1 and T2 was compared with T0 after the anesthesia,and the difference was statistically significant(P<0.05).The blood pH of the gasless group and the pneumoperito

关 键 词：免气腹腹腔镜 气腹腹腔镜 卵巢囊肿 麻醉安全性 

分 类 号：R737.3[医药卫生—肿瘤]