加温加湿CO_(2)人工气腹在腹腔镜肝切除术中的应用  

The Effects of Warmed and Humidified CO_(2) Pneumoperitoneum on Patients with Laparoscopic Hepatectomy

作　　者：王海燕[1] WANG Hai-yan(Department of Operating Rooms,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院手术室,南昌330006

出　　处：《实用临床医学（江西）》2024年第6期67-70,共4页Practical Clinical Medicine

基　　金：江西省教育厅科学技术研究项目(190091)。

摘　　要：目的探讨加温加湿CO_(2)气腹对经腹腔镜肝切除患者体温、血淋巴细胞与C反应蛋白比率(LCR)的影响。方法收集经腹腔镜下肝切除患者96例,按人工气腹时CO_(2)温度和湿度的不同分为常规气腹组(常规组,n=46)和加温加湿人工气腹组(干预组,n=50),常规组应用常温CO_(2)气体(冷CO_(2)气体,相对湿度20%)建立气腹,干预组应用加温至37℃,湿度保持在98%的CO_(2)气体建立气腹。监测围手术期的膀胱温度,检测血常规,ELISA法检测血清LCR水平,比较术前(T0),人工气腹后10 min(T1)、60 min(T2)、90 min(T3),术后60 min(T4)或术后24 h(T5)2组深部体温和LCR的变化。结果深部体温比较:T0、T1时2组差异无统计学意义(P>0.05),T2、T3、T4时干预组高于常规组(P<0.05)。LCR比较:T0时2组差异无统计学意义(P>0.05),T1、T2、T3、T5时干预组较常规组下降得更缓慢(P<0.05)。结论加温加湿CO_(2)气腹在经腹腔镜肝切除术中可有效减少术中、术后低体温的发生,保护患者的免疫功能可减少低体温带来的并发症。Objective To investigate the effects of warmed and humidified CO_(2) pneumoperitoneum on body temperature and blood lymphocyte to C-reactive protein ratio(LCR)in patients undergoing laparoscopic hepatectomy.Methods The data for 96 patients who underwent laparoscopic hepatectomy were collected and they were randomly divided into 2 groups based on CO_(2) temperature and humidity during artificial pneumoperitoneum:a conventional pneumoperitoneum group(conventional group,n=46)and a warmed and humidified pneumoperitoneum group(intervention group,n=50).In the conventional group,pneumoperitoneum was established using normal temperature CO_(2)(cold CO_(2) with 20%relative humidity),whereas in the intervention group,pneumoperitoneum was created using CO_(2) that had been warmed to 37℃and maintained at 98%humidity.Perioperative bladder temperature was monitored,routine blood tests were conducted,and serum LCR levels were measured using ELISA.Changes in deep body temperature and LCR were compared between the 2 groups at preoperative time point(T0),10 minutes(T1),60 minutes(T2),and 90 minutes(T3)after pneumoperitoneum,as well as 60 minutes(T4)and 24 hours(T5)postoperatively.Results In terms of deep body temperature,there was no statistically significant difference between the 2 groups at T0 and T1(P>0.05);however,at T2,T3,and T4,the intervention group had higher deep body temperatures than the conventional group(P<0.05).In terms of LCR,there was no statistically significant difference between the 2 groups at T0(P>0.05),and at T1,T2,T3,and T5,the intervention group showed a slower decrease in LCR compared to the conventional group(P<0.05).Conclusion Warmed and humidified CO_(2) pneumoperitoneum can positively reduce the occurrence of intraoperative and postoperative hypothermia in patients with laparoscopic hepatectomy,contributing to the protection of immune function and the mitigation of hypothermia-related complications among patients.

关 键 词：肝切除术 人工气腹 37℃CO_(2) 98%湿度CO_(2) 深部体温 血淋巴细胞术与C反应蛋白比率 

分 类 号：R473.6[医药卫生—护理学]