两组气腹压力应用于腹腔镜下胃癌根治术患者的效果对比  

The Results of the Two Groups of Pneumoperitoneum Pressure Applied to Patients Undergoing Laparoscopic Radical Gastrectomy

作　　者：林海霞 LIN Hai-xia(Operating Room of the First Hospital of Putian City,Fujian Province,Fujian Putian 351100)

机构地区：[1]福建省莆田市第一医院手术室,福建莆田351100

出　　处：《中国医疗器械信息》2024年第24期11-13,81,共4页China Medical Device Information

摘　　要：目的:探讨两组气腹压力应用于腹腔镜下胃癌根治术患者的效果。方法:选择2021年6月~2023年6月于本院行腹腔镜下胃癌根治术患者80例。按照乱数表法分为对照组40例采用气腹压力为12mmHg,观察组40例采用气腹压力为8mmHg,观察两组手术相关指标、肠道功能[血浆D-乳酸(D-LA)、二胺氧化酶(DAO)浓度]、肝肾功能[N-乙酰-β-D-葡萄糖苷酶(NAG)、胱抑素C(Cys C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、肌酐(Cr)、尿素氮(BUN)、尿量]、并发症。结果:与对照组比较,观察组手术结束时体温明显更高,肠鸣音出现时间、排气时间、住院时间明显更短(P<0.05)。术前,两组D-LA、DAO浓度比较无差异(P>0.05);术后24h,与对照组比较,观察组D-LA、DAO浓度明显更低(P<0.05)。术前,两组NAG、Cys C、ALT、AST、Cr、BUN水平及尿量比较无差异(P>0.05);术后24h,与对照组比较,观察组NAG、Cys C、Cr、BUN水平明显更低,ALT、AST水平及尿量明显更高(P<0.05)。两组并发症发生率比较,结果无显著差异(P>0.05)。结论:在进行腹腔镜下胃癌根治术时使用8mmHg的气腹压力,可有效减缓手术时体温下降幅度,缩短住院时间,减轻对肠道功能以及肝肾功能的损伤,且安全性较好。Objective:To explore the effect of two groups of pneumoperitoneum pressure in patients undergoing laparoscopic radical gastrectomy.Methods:80 patients undergoing laparoscopic radical resection for gastric cancer were selected from June 2021 to June 2023.According to the random counting method,40 patients had pneumoperitoneum pressure of 12mmHg,and 40 patients used pneumoperitoneum pressure of 8mmHg for surgery-related indicators,intestinal function[plasma D-lactate(D-LA),diamine oxidase(DAO)concentration],liver and kidney function[N-acetyl-β-D-glucosidase(NAG),cystatin C(CysC),alanine aminotransferase(ALT),aspartate amino-transferase(AST),creatinine(Cr),urea nitrogen(BUN),urine volume]and complications.Results:Compared with the control group,the body temperature was significantly higher at the end of surgery,and the time of bowel sound onset,exhaust time,and hospitalization time were significantly shorter(P<0.05).Before surgery,there was no difference in D-LA and DAO concentrations between the two groups(P>0.05);24h after surgery,D-LA and DAO concentrations in the observation group were significantly lower compared with the control group(P<0.05).NAG,CysC,ALT,AST,Cr,and urine volume were not different between the two groups(P>0.05);At 24h after surgery,NAG,CysC,Cr,BUN were significantly lower,ALT,AST,and urine volume were significantly higher in the control group(P<0.05).Comparing the complication rate of the two groups,the results were not significantly different(P>0.05).Conclusion:The use of 8mmHg pneumoperitoneum pressure during laparoscopic radical gastrectomy can effectively reduce the temperature drop during surgery,shorten the hospital stay,reduce the damage to intestinal function and liver and kidney function,and have good safety.

关 键 词：腹腔镜 胃癌根治术 气腹压力 肠道功能 肝肾功能 

分 类 号：R735.2[医药卫生—肿瘤]