[1]张景华①,曹月敏,胡万宁①,等.腹腔镜胆囊切除术不同压力CO2气腹对气腹存留时限及肩部疼痛的影响[J].中国微创外科杂志,2007,07(2):103-105.
　Zhang Jinghua,Cao Yuemin*,Hu Wanning,et al.Effects of different CO2 pressure on duration of pneumoperitoneum and shoulder pain following laparoscopic cholecystectomy[J].Chinese Journal of Minimally Invasive Surgery,2007,07(2):103-105.
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腹腔镜胆囊切除术不同压力CO2气腹对气腹存留时限及肩部疼痛的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年2期
页码:
103-105
栏目:
出版日期:
2007-02-20

文章信息/Info

Title:
Effects of different CO2 pressure on duration of pneumoperitoneum and shoulder pain following laparoscopic cholecystectomy
作者:
张景华①; 曹月敏; 胡万宁①; 江建军; 王兰辉
河北省人民医院普外科，石家庄050051
Author(s):
Zhang Jinghua;  Cao Yuemin*;  Hu Wanning;  et al.
*Department of General Surgery, People’s Hospital of Hebei Province, Shijiazhuang 050051, China
关键词:
气腹; 腹腔镜胆囊切除术; 肩部疼痛
Keywords:
Pneumoperitoneum; Laparoscopic cholecystectomy; Shoulder pain
分类号:
R657.4；R746
文献标志码:
A
摘要:
目的探讨腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）不同压力CO2气腹对气腹存留时限及肩部疼痛的影响，探讨LC术后气腹存留时限的影响因素及肩部疼痛的原因。方法2002年4～10月连续观察69例LC，随机分为A、B、C 3组，每组23例。气腹压力设定A组10 mm Hg，B组12 mm Hg，C组14 mm Hg。对69例LC术后进行连续胸部X线平片观察膈下游离气体，测量术后24 h两侧膈下游离气体的长、高并计算残气量。采用视觉模拟评分(vision analogue score，VAS)观察3组术后1、3、6、12、24、48、72、96、120 h肩部疼痛程度。结果LC后气腹存留时限为（1.8±1.1）d，男女组气腹存留时限分别为（1.8±1.1）d和（1.7±1.0）d，2组比较无显著意义（H=0.013，P=0.911）。3组术后24 h膈下残气量及术后气腹存留时限差异无显著性（P>0.05）。逐步回归分析示lg（气腹存留时限）与术后24 h膈下残气量呈正相关（r=0616，P=0.006），与气腹时间呈负相关（r=-0.228，P=0.014），与年龄、体重、身高、手术时间及所用气体量无相关性。术后26例出现肩部疼痛，随着A、B、C 3组气腹压力的增高，发生肩部疼痛患者的VAS评分明显增高(F=9.635, P=0.000)，术后24 h肩部疼痛VAS评分与术后24 h右侧膈下残气量呈正相关（r=0.333，P=0.005），与气腹存留时限呈正相关（r=0.296，P=0014）。结论LC术毕尽量将腹腔内CO2气体排净可缩短术后残气吸收时间。不同压力CO2气腹对LC术后残余的CO2气体量及气腹存留时限无明显影响。LC后肩部疼痛程度随气腹压增高有明显加重趋势，人工气腹引起膈肌的张力可能是造成肩部疼痛的重要原因。
Abstract:
ObjectiveTo observe the effects of different CO2 pneumoperitoneum pressure on duration of residual gas and shoulder pain following laparoscopic cholecystectomy (LC), and to identify factors which affect resolution time and shoulder pain.MethodsSixtynine

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备注/Memo

备注/Memo:
①（唐山市人民医院肿瘤外科，唐山063001）
更新日期/Last Update: 2013-11-15