低腹压腹壁悬吊法在腹腔镜胃癌根治术患者中的应用效果  

Application effect of low pneumoperitoneum pressure abdominal wall suspension in patients with laparoscopic radical gastrectomy

作　　者：贾学凡 张彩举[1] 王宗崇 廖天龙 刘国辉 JIA Xuefan;ZHANG Caiju;WANG Zongchong;LIAO Tianlong;LIU Guohui(Operating Room,Nanyang First People’s Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市第一人民医院手术室,河南南阳4730000

出　　处：《癌症进展》2024年第3期306-309,共4页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191449)。

摘　　要：目的探讨低腹压腹壁悬吊法在腹腔镜胃癌根治术患者中的应用效果。方法依据术中腹腔压力的不同将98例腹腔镜胃癌根治术患者分为常规组(n=49)和低腹压组(n=49),常规组患者术中采用常规腹压手术,低腹压组患者术中采用低腹压腹壁悬吊法。比较两组患者的手术指标、循环功能指标[心率(HR)、平均动脉压(MAP)、眼压(IOP)]、呼吸功能指标[呼气末二氧化碳分压(PETCO_(2))、气道峰压(Ppeak)]、术后指标及并发症发生情况。结果低腹压组患者术中出血量明显少于常规组,差异有统计学意义(P﹤0.01)。气腹建立15 min,两组患者HR、MAP、IOP、PETCO_(2)、Ppeak均高于本组麻醉前,低腹压组患者HR、MAP、IOP、PETCO_(2)、Ppeak均低于常规组,差异均有统计学意义(P﹤0.05)。术后,低腹压组患者肠鸣音恢复时间、首次排气时间、首次排便时间、首次下床时间、术后住院时间均短于常规组,差异均有统计学意义(P﹤0.05)。低腹压组患者术后并发症总发生率为4.08%,低于常规组患者的16.33%,差异有统计学意义(P﹤0.05)。结论低腹压腹壁悬吊法应用于腹腔镜胃癌根治术患者具有较高的安全性,能有效减轻对患者循环、呼吸功能的不良影响,促进患者的术后恢复,并且降低术后并发症发生率。Objective To investigate the application effect of low pneumoperitoneum pressure abdominal wall suspension in patients with laparoscopic radical gastrectomy.Method A total of 98 laparoscopic radical gastrectomy patients were divided into conventional group(n=49)and low abdominal pressure group(n=49)according to the intraoperative abdominal pressure.Conventional abdominal pressure operation was performed in the conventional group,while low pneumoperitoneum pressure abdominal wall suspension was performed in the low abdominal pressure group.The surgical indicators,circulatory function indicators[heart rate(HR),mean arterial pressure(MAP),intraocular pressure(IOP)],respiratory function indicators[partial pressure of end-tidal carbon dioxide(PETCO_(2)),peak airway pressure(Ppeak)],postoperative indicators and incidence of complications were compared between the two groups.Result The intraoperative blood loss in the low abdominal pressure group was significantly less than that in the conventional group,and the difference was statistically significant(P<0.01).After 15 minutes of pneumoperitoneus establishment,HR,MAP,IOP,PETCO_(2) and Ppeak in two groups were higher than those before anesthesia,and the HR,MAP,IOP,PETCO_(2) and Ppeak in low abdominal pressure group were lower than those in conventional group,and the differences were statistically significant(P<0.05).After operation,the recovery time of bowel sound,first exhaust time,first defecation time,first getting out of bed time and postoperative hospitalization time of patients in low abdominal pressure group were significantly shorter than those in conventional group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the low abdominal pressure group was 4.08%,which was lower than 16.33% in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Low abdominal pressure abdominal wall suspension has a high safety in patients undergoing laparoscopic radical gastrectomy,whi

关 键 词：腹腔镜胃癌根治术 低腹压腹壁悬吊法 循环功能 呼吸功能 术后恢复 

分 类 号：R735.2[医药卫生—肿瘤]