悬吊式无气腹腹腔镜对妇科手术患者呼吸循环、费用-效果的影响研究  

Effects of suspended gasless laparoscopy on respiratory cycle and cost-effectiveness of patients undergoing gynecological surgery

作　　者：李红 宋桂英 LI Hong;SONG Gui-ying(Department of Gynecology,Maternal and Child Health Hospital of Qinhuangdao City,Qinhuangdao Hebei 063000,China)

机构地区：[1]秦皇岛市妇幼保健院妇科,河北秦皇岛063000

出　　处：《临床和实验医学杂志》2021年第11期1212-1216,共5页Journal of Clinical and Experimental Medicine

基　　金：秦皇岛市科技局科研项目(编号:162502-3-2)。

摘　　要：目的探讨悬吊式无气腹腹腔镜对妇科手术患者呼吸循环、费用-效果的影响研究。方法回顾性选取2015年12月至2018年12月秦皇岛市妇幼保健院收治的行妇科手术86例患者,根据手术方式的不同将其分为研究组(n=44)和对照组(n=42),对照组给予气腹腹腔镜手术治疗,研究组给给予悬吊式无气腹腹腔镜手术治疗。观察比较2组患者手术时间、术中出血量、手术费用。记录比较2组患者术前、术后24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、最大呼气流量(PEF)、一秒钟用力呼气量预计值(FEV1%)以及血清细胞白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平。记录2组患者术后3个月内并发症发生情况。结果研究组患者手术时间为(72.28±10.62)min,明显短于对照组[(88.49±15.45)min],术中出血量、手术费用分别为(80.50±20.88)mL、(1.01±0.28)万元,明显少于对照组[(110.98±26.57)mL、(1.30±0.25)万元],差异均有统计学的意义(P<0.05)。术前,2组患者24 h SBP、24 h DBP、PEF、FEV1%比较,差异均无统计学意义(P>0.05);术后24 h,研究组患者24 h SBP、24 h DBP为(125.14±20.21)、(79.13±4.12)mmHg,明显低于对照组[(143.41±20.26)、(92.57±5.26)mmHg],PEF、FEV1%为(2.60±0.49)L、(64.68±1.57)%,明显高于对照组[(2.04±0.51)L、(60.44±1.30)%],差异均有统计学的意义(P<0.05)。术前,2组患者血清IL-6、IL-8水平比较,差异均无统计学意义(P>0.05);术后24 h,研究组血清IL-6、IL-8水平为(16.21±2.66)、(8.29±4.41)pg/mL明显低于对照组[(18.55±2.84)、(12.36±5.17)pg/mL],差异均有统计学的意义(P<0.05)。研究组患者术后3个月内并发症总发生率4.55%,明显低于对照组的19.05%,差异有统计学的意义(P<0.05)。结论与气腹腹腔镜相比,悬吊式无气腹腹腔镜能缩短妇科手术患者的手术时间呼吸,减少术中出血量,改善呼吸循环功能,降低炎症反应,减少术后并发症,同时手术费用更低廉。Objective To study the effects of suspended gasless laparoscopy on respiratory cycle and cost-effectiveness of patients undergoing gynecological surgery.Methods Eighty-six patients who underwent gynecological surgery in the Maternal and Child Health Hospital of Qinhuangdao City from December 2015 to December 2018 were enrolled.According to the different surgical methods,they were divided into study group(n=44)and control group(n=42).The control group was treated with pneumoperitoneum laparoscopy,while study group was treated with suspended gasless laparoscopy.The operation time,intraoperative blood loss and surgical cost were observed and compared between the two groups.The levels of 24 h mean systolic blood pressure(24 h SBP),24 h mean diastolic blood pressure(24 h DBP),peak expiratory flow(PEF),forced expiratory volume in 1 second as as percentage of predicted value(FEV1%),serum interleukin-6(IL-6)and interleukin-8(IL-8)before and 24 h after surgery were recorded and compared between the two groups.The occurrence of complications in both groups within 3 months after surgery was recorded.Results The operation time of the patients in the study group was(72.28±10.62)min,which was significantly shorter than in the control group[(88.49±15.45)min].The intraoperative blood loss and operation cost were(80.50±20.88)mL and(1.01±0.28)ten thousand yuan,which were significantly less than those in the control group[(110.98±26.57)mL,(1.30±0.25)ten thousand yuan],the differences were statistically significant(P<0.05).Before surgery,there was no significant difference in 24 h SBP,24 h DBP,PEF,and FEV between the two groups of patients(P>0.05);24 h after surgery,the 24 h SBP and 24 h DBP in the study group were(125.14±20.21),(79.13±4.12)mmHg,which were significantly lower than those in the control group[(143.41±20.26),(92.57±5.26)mmHg],PEF,FEV1%were(2.60±0.49)L,(64.68±1.57)%,which were significantly higher than those in the control group[(2.04±0.51)L,(60.44±1.30)%],and the differences were statistically significant

关 键 词：妇科手术患者 悬吊式无气腹腹腔镜 呼吸循环 费用-效果 

分 类 号：R713[医药卫生—妇产科学]