[1]曾 强.不同气腹压对胆囊结石患者行腹腔镜胆囊切除术后肝肠功能的影响[J].医学信息,2024,37(15):75-78.[doi:10.3969/j.issn.1006-1959.2024.15.016]
　ZENG Qiang.Effect of Different Pneumoperitoneum Pressure on Liver and Intestinal Function After Laparoscopic Cholecystectomy in Patients with Gallstones[J].Journal of Medical Information,2024,37(15):75-78.[doi:10.3969/j.issn.1006-1959.2024.15.016]
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不同气腹压对胆囊结石患者行腹腔镜胆囊切除术后肝肠功能的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年15期
页码:
75-78
栏目:
论著
出版日期:
2024-08-01

文章信息/Info

Title:
Effect of Different Pneumoperitoneum Pressure on Liver and Intestinal Function After Laparoscopic Cholecystectomy in Patients with Gallstones
文章编号:
1006-1959（2024）15-0075-04
作者:
曾 强
（上饶市广信区中医院外科，江西 上饶 334109）
Author(s):
ZENG Qiang
(Department of Surgery,Guangxin District Hospital of Traditional Chinese Medicine,Shangrao 334109,Jiangxi,China)
关键词:
气腹压; 胆囊结石; 腹腔镜胆囊切除术; 肝肠功能
Keywords:
Pneumoperitoneum pressure; Gallstones; Laparoscopic cholecystectomy; Liver and intestinal function
分类号:
R657.4
DOI:
10.3969/j.issn.1006-1959.2024.15.016
文献标志码:
A
摘要:
目的 研究不同气腹压对胆囊结石患者行腹腔镜胆囊切除术后肝肠功能的影响。方法 选取2020年3月-2023年3月我院行腹腔镜胆囊切除术的60例胆囊结石患者为研究对象，采用随机数字表法分为对照组和观察组，各组30例。观察组采用低气腹压（8~12 mmHg），对照组采用高气腹压（13~15 mmHg），比较两组术后疼痛评分（VAS）、术后胃肠功能恢复指标（首次排气、肠道鸣音恢复及大便时间）、血流动力学指标[二氧化碳分压（PaCO2）、平均动脉压（MAP）]、肝功能指标[丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）]、并发症发生率。结果 观察组术后12、24 h的VAS评分低于术前，且观察组低于对照组（P＜0.05）；观察组术后首次排气、肠道鸣音恢复、首次大便时间短于对照组（P＜0.05）；两组气腹后10 min的PaCO2、MAP高于气腹前，但观察组低于对照组（P＜0.05）；两组术后第1天ALT、AST高于术前，但组间比较，差异无统计学意义（P>0.05）；观察组并发症发生率为6.67%，低于对照组的20.00%（P＜0.05）。结论 不同气腹压对胆囊结石患者行腹腔镜胆囊切除术后肝肠功能会造成不同影响，相对而言低气腹压（8~12 mmHg）患者术后胃肠功能恢复快速，且可减轻术后疼痛度，降低并发症发生率，减轻对肝功能和血流动力学的影响。
Abstract:
Objective To study the effect of different pneumoperitoneum pressure on liver and intestinal function after laparoscopic cholecystectomy in patients with gallstones.Methods A total of 60 patients with cholecystolithiasis who underwent laparoscopic cholecystectomy in our hospital from March 2020 to March 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The observation group was treated with low pneumoperitoneum pressure (8-12 mmHg), and the control group was treated with high pneumoperitoneum pressure (13-15 mmHg). The postoperative pain score (VAS), postoperative gastrointestinal function recovery index (first exhaust, intestinal sound recovery and stool time), hemodynamic index [carbon dioxide partial pressure (PaCO2), mean arterial pressure (MAP)], liver function index [alanine aminotransferase (ALT), aspartate aminotransferase (AST)] and complication rate were compared between the two groups.Results The VAS score of the observation group at 12 and 24 hours after operation was lower than that before operation, and the observation group was lower than the control group (P<0.05). The time of first exhaust, recovery of bowel sounds and first defecation in the observation group were shorter than those in the control group (P<0.05). The PaCO2 and MAP at 10 min after pneumoperitoneum in the two groups were higher than those before pneumoperitoneum, but the observation group was lower than the control group (P<0.05). ALT and AST on the first day after operation in the two groups were higher than those before operation, but there were no significant difference between the observation group and the control group(P>0.05). The incidence of complications in the observation group was 6.67%, which was lower than 20.00% in the control group (P<0.05).Conclusion Different pneumoperitoneum pressures have different effects on liver and intestinal function after laparoscopic cholecystectomy in patients with gallstones. Relatively speaking, patients with low pneumoperitoneum pressure (8-12 mmHg) have rapid recovery of gastrointestinal function after operation, and can reduce postoperative pain, reduce the incidence of complications, and reduce the impact on liver function and hemodynamics.

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更新日期/Last Update: 1900-01-01