实时超声监测不同通气压力对腹腔镜手术患者胃胀气及恶心呕吐的影响  

Effects of Real-time Ultrasound Monitoring of Different Ventilation Pressures on Flatulence and Nausea and Vomiting in Patients with Laparoscopic Surgery

作　　者：严小健 蒙斌 钟品华 YAN Xiaojian;MENG Bin;ZHONG Pinhua(The Second People’s Hospital of Nankang District of Ganzhou City,Jiangxi Province,Ganzhou 341411,China;不详)

机构地区：[1]江西省赣州市南康区第二人民医院,江西赣州341411

出　　处：《中国医学创新》2022年第22期118-121,共4页Medical Innovation of China

基　　金：赣州市指导性科技计划项目(GZ2021ZSF469)。

摘　　要：目的:探究实时超声监测不同通气压力对腹腔镜手术患者胃胀气及恶心呕吐的影响。方法:选取2021年1-12月赣州市南康区第二人民医院收治的60例腹腔镜手术患者,采用随机数字表法分为A1、A2、A3三组,每组20例。A1、A2、A3三组分别使用10、15、20 cmH_(2)O压力的面罩通气。比较三组面罩通气前(T_(0))和面罩通气180 s(T_(1))时胃窦部横截面积(CSA)、胃肠胀气发生情况、潮气量(VT)和呼气末二氧化碳分压(PETCO_(2));比较三组T_(1)时低氧血症发生情况;比较三组手术时间、术后48 h胃肠胀气和恶心呕吐发生情况。结果:T_(0)时,三组CSA比较,差异无统计学意义(P>0.05);T_(1)时,A1组和A3组CSA大于A2组,差异均有统计学意义(P<0.05)。T_(0)时,三组胃肠胀气发生率比较,差异无统计学意义(P>0.05)。T_(1)时,三组CSA和胃肠胀气发生率比较,差异均无统计学意义(P>0.05)。三组低氧血症发生率比较,差异无统计学意义(P>0.05)。T_(0)时,三组VT、PETCO_(2)比较,差异均无统计学意义(P>0.05);T_(1)时,A1组和A3组VT、PETCO_(2)均高于A2组,差异均有统计学意义(P<0.05)。三组手术时间和术后48 h恶心呕吐发生率比较,差异均无统计学意义(P>0.05)。三组术后48 h胃肠胀气发生率比较,差异有统计学意义(P<0.05)。A2组术后48 h胃肠胀气发生率低于A3组,差异有统计学意义(P<0.05)。结论:15 cmH_(2)O压力的面罩通气是腹腔镜手术患者适宜的通气压力,还可以降低术后48 h胃肠胀气发生率。Objective:To investigate the effect of real-time ultrasound monitoring of different ventilation pressures on flatulence and nausea and vomiting in patients with laparoscopic surgery.Method:A total of 60 laparoscopic surgery patients admitted to the the Second People’s Hospital of Nankang District of Ganzhou City from January to December 2021 were selected,they were divided into group A1,group A2 and group A3 according to random number table method,with 20 cases in each group.group A1,A2 and A3 were ventilated with masks of 10,15 and 20 cmH_(2)O pressures,respectively.Gastric antrum cross sectional area (CSA),flatulence,tidal volume (VT) and end-tidal carbon dioxide partial pressure (PETCO_(2)) before mask ventilation (T_(0)) and 180 s (T_(1)) were compared among three groups;the incidence of hypoxemia at T_(1) was compared among three groups;the time of surgery,the occurrence of flatulence and nausea and vomiting 48 h after surgery were compared among three groups.Result:At T_(0),there was no significant difference in CSA among three groups (P>0.05).At T_(1),CSA in the group A1 and A3 were greater than that in the group A2,the differences were statistically significant (P<0.05).At T_(0),there was no significant difference in the incidence of flatulence among three groups (P>0.05).At T_(1),there were no significant differences in CSA and the incidence of flatulence among three groups (P>0.05).There was no significant difference in the incidence of hypoxemia among the three groups (P>0.05).At T_(0),there was no significant difference in VT and PETCO_(2) among three groups (P>0.05).At T_(1),VT and PETCO_(2) in the group A1 and A3 were higher than those in the group A2,the differences were statistically significant (P<0.05).There were no significant differences in surgery time and incidence of nausea and vomiting 48 h after surgery among three groups (P>0.05).There was statistically significant difference in the incidence of flatulence 48 h after surgery among the three groups (P<0.05).The incidence of flatulence 4

关 键 词：腹腔镜手术 超声监测 通气压力 恶心呕吐 胃胀气 

分 类 号：R656[医药卫生—外科学]