期刊文献+

腹腔镜结直肠癌手术中CO_2气腹压力对急性胃肠损伤的影响 被引量:19

Effect of CO_2 Pneumoperitoneum Pressure on Acute Gastrointestinal Injury in Laparoscopic Surgery for Colorectal Cancer
下载PDF
导出
摘要 目的探讨腹腔镜下结直肠癌手术中CO_2气腹压力对急性胃肠损伤(acute gastrointestinal injury,AGI)的影响。方法根据入选标准选取我院自2010年10月至2016年9月收治的119例行腹腔镜下结直肠癌根治性切除术的患者,按照随机数字表法分为A、B、C三组,A组40例,术中气腹压力设为10 mm Hg;B组40例,术中气腹压力设为12 mm Hg;C组39例,术中气腹压力设为15 mm Hg。比较三组患者术中情况、术后各项指标恢复情况、血浆D-乳酸水平及术后并发症情况。结果三组患者手术持续时间、术中出血量及气腹持续时间比较差异无统计学意义(P>0.05);三组患者术后各项指标恢复情况(术后首次排气/排便时间、首次肠鸣音时间、术后首次进食时间)差异无统计学意义(P>0.05);血浆D-乳酸水平在术前、术后48 h三组比较差异无统计学意义(P>0.05);术后2 h、24 h时C组血浆D-乳酸水平显著高于A、B两组,差异具有统计学意义(P<0.05);三组术后并发症发生率(乳糜漏、吻合口瘘、急性胃肠损伤、术后出血、肠麻痹)差异无统计学意义(P>0.05)。结论在腹腔镜结直肠癌手术中CO_2气腹压力在10~15 mm Hg范围内对急性胃肠损伤的出现无明显影响,但尽量应控制在15 mm Hg以下。 Objective To investigate the effect of CO_2 pneumoperitoneum pressure on acute gastrointestinal injury(AGI) in laparoscopic colorectal cancer resection. Methods 119 patients with colorectal cancer undergoing laparoscopic radical resection were selected from October 2010 to September 2016. According to the random number table method,they were divided into 3 groups. The intraoperative pneumoperitoneum pressure was set to 10 mm Hg,12 mm Hg and 15 mm Hg in group A,B,C respectively. Comparison of the three groups was carried out about intraoperative conditions,postoperative recoveries,plasma D-lactate levels and postoperative complications. Results There was no significant difference in the duration of operation,the amount of intraoperative blood loss,the duration of pneumoperitoneum,and postoperative first exhaust/defecation time among the three groups(P 0. 05). The levels of D-lactic acid in group C were significantly higher than that of group A and B 2 hours and 24 hours after operation(P 0. 05). There was no significant difference among the three groups in the incidence of postoperative complications(chylous leakage,anastomotic fistula,acute gastrointestinal injury,postoperative hemorrhage and intestinal paralysis). Conclusion There is no significant effect of CO_2 pneumoperitoneum pressure on the appearance of acute gastrointestinal injury in the range of 10 ~ 15 mm Hg during laparoscopic colorectal cancer resection.
出处 《中国现代手术学杂志》 2017年第2期94-98,共5页 Chinese Journal of Modern Operative Surgery
关键词 腹腔镜手术 结直肠癌 气腹压力 急性胃肠损伤 laparoscopic surgery colorectal cancer pneumoperitoneal pressure acute gastrointestinal injury
  • 相关文献

参考文献9

二级参考文献95

  • 1周晓武.对腹腔镜直肠癌根治术的几点思考[J].中华临床医师杂志(电子版),2012,6(21):6630-6632. 被引量:4
  • 2刘尚梅,黄受方,廖松林.关于结直肠活检中癌及前驱病变诊断问题研讨会纪要[J].中华病理学杂志,2004,33(3):303-304. 被引量:2
  • 3郭曲练.腔镜手术的麻醉[M].见:徐启明,李文硕,主编.临床麻醉学.第1版,北京:人民卫生出版社,2000.364—369.
  • 4Cholley BP,Singer M.Esophageal Doppler: noninvNslve cardiac output monitor[J].E- chocardiography, 2003,20(8) : 763 -9.
  • 5Rist Mo Rauh R,Klingel R,et M.Hemo- dynamic effects of pneumoper-itoneum in lithotomy position [J].Zentralbl Chir, 2001,126(1) :75-9.
  • 6Wynne JL,Ovadje LO,Akridge CM,et al. Impedance cardiography : apotential moni- tor for hemodialysis [J].J Surg Res, 2006,133(1): 55-60.
  • 7Dazzani F,Micati M,Caraeeni P,et al. Transthoraeic eleetriealhi oimpedance : a non-invasive technique for the evaluation of the haemodynamic alterations in pa- tients with liver cirrhosis[J].Dig Liver Dis, 2005,37(10) : 786-792.
  • 8Koliopanos A,Zografos G,Skiathitis S,et al.Esophageal Doppler (OMDII)improves intraoperative hemodynamic monitoring during laparoscopic surgery [J].Surg La- parosc Endosc Percutan Tech,2005,15 (6) : 332-338.
  • 9Meininger D,Byhahn C,Mierdl S,et al. Hemodynamie and respiratory effects of robot-assisted laparoseopic fundoplication in children [J].World J Surg,2005,29(5): 615-619.
  • 10The king by, Ren Zhanli, Du Menghua, et al. Early stroke syndromes affecting factors research [ J ]. Journal of Beijing University of Chinese Medicine,2012,19(4) :43N46.

共引文献330

同被引文献192

引证文献19

二级引证文献116

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部