不同气腹压力对胆囊切除术患者肾功能、肺功能及应激激素的影响比较  

Comparison on the Influence of Different Pneumoperitoneum Pressure for Renal Function,Pulmonary Function and Stress Hormones of Patients with Cholecystectomy

作　　者：王飞 付勇超 WANG Fei;FU Yongchao(Hepatobiliary Surgery Department,Chongqing Global Cancer Hospital,Chongqing 404100,China;不详)

机构地区：[1]重庆全域肿瘤医院肝胆外科,重庆404100

出　　处：《中国医学创新》2025年第6期50-54,共5页Medical Innovation of China

摘　　要：目的:探究及比较不同气腹压力对胆囊切除术患者肾功能、肺功能及应激激素的影响。方法:将2022年11月—2024年2月重庆全域肿瘤医院的82例胆囊切除术患者根据随机数字表法分为A组与B组,各41例。A组的气腹压力为13~15 mmHg,B组的气腹压力为8~12 mmHg。比较两组气腹前后的血流动力学[收缩压(SBP)、舒张压(DBP)及心率(HR)],术前及术后1、2、3、5 d的肾功能[尿素氮(BUN)、血肌酐(Scr)及胱抑素C(Cys C)]、肺功能[第1秒用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pred)]及应激激素[皮质醇(Cor)、醛固酮(ALD)、血糖(Glu)]。结果:气腹前两组的血流动力学指标比较,差异均无统计学意义(P>0.05);气腹后10 min及20 min,B组的血流动力学指标均显著低于A组(P<0.05);术前及术后5 d两组的肾功能、肺功能及应激激素比较,差异均无统计学意义(P>0.05);术后1、2、3 d,B组的肾功能及应激激素指标均显著低于A组,肺功能指标均显著高于A组(P<0.05)。结论:气腹压力8~12 mmHg对胆囊切除术患者肾功能、肺功能及应激激素的影响相对较小,较低的气腹压力更为适用于胆囊切除术患者。Objective:To investigate and compare the influence of different pneumoperitoneum pressure for renal function,pulmonary function and stress hormones of patients with cholecystectomy.Method:A total of 82 patients with cholecystectomy in Chongqing Global Cancer Hospital from November 2022 to February 2024 were divided into group A and group B according to random number table method,with 41 cases each.The pneumoperitoneum pressure of group A was 13 to 15 mmHg,the pneumoperitoneum pressure of group B was 8 to 12 mmHg.Then the hemodynamics[systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)]before and after the pneumoperitoneum,renal function[blood urea nitrogen(BUN),blood creatinine(Scr)and Cystatin C(Cys C)],pulmonary function[the percentage of forced expiratory volume in the first second to the expected value(FEV1%pred)and forced vital capacity as a percentage of projected value(FVC%pred)]and stress hormones[cortisol(Cor),aldosterone(ALD)and glucose(Glu)]before the operation and at 1st,2nd,3rd and 5th day after the operation of two groups were compared.Result:The hemodynamic indexes of two groups before the pneumoperitoneum were compared,the differences were not statistically significant(P>0.05);the hemodynamic indexes of group B at 10 min and 20 min after the pneumoperitoneum were significantly lower than those of group A(P<0.05);the renal function,pulmonary function and stress hormones of two groups before the operation and at 5th day after the operation were compared,the differences were not statistically significant(P>0.05),the renal function and stress hormone indexes of group B at 1st,2nd and 3rd day after the operation were significantly lower than those of group A,the pulmonary function were significantly higher than those of group A(P<0.05).Conclusion:The influence of pneumoperitoneum pressure 8 to 12 mmHg for renal function,pulmonary function and stress hormone of patients with cholecystectomy are relatively smaller,and lower pneumoperitoneum pressure is more suitable to the patien

关 键 词：气腹压力 胆囊切除术 肾功能 肺功能 应激激素 

分 类 号：R657.4[医药卫生—外科学]