解放军医药杂志2017，Vol.29Issue(9)：92-95,4.DOI:10.3969/j.issn.2095-140X.2017.09.024
不同气腹压对行腹腔镜胆囊切除术合并乙型病毒性肝炎患者手术期血流动力学及术后肝功能的影响
Effects of Different Pneumoperitoneum Pressures on Perioperative Hemodynamics and Postoperative Liver Func-tion Recovery in Patients Undergoing Laparoscopic Cholecystectomy Combined with Viral Hepatitis Type B
摘要
Abstract
Objective To investigate effects of different pneumoperitoneum pressures on perioperative hemody-namics and postoperative liver function recovery in patients undergoing laparoscopic cholecystectomy combined with viral hepatitis type B. Methods clinical data of 93 patients undergoing laparoscopic cholecystectomy combined with viral hepatitis type B admitted during April 2015 and October 2013 was retrospectively analyzed, and the patients were divided into low pneumoperitoneum pressure group (8-12 mmHg pneumoperitoneum pressure, n=50) and high pneumoperitone-um pressure group (13-15 mmHg pneumoperitoneum pressure, n=43) according to different surgical pneumoperitoneum pressures. Operation success rate, hemodynamic indexes during operation, liver function indexes and incidence rate of complications before and after operation were compared between the two groups. Results There was no significant differ-ence in success rate of operation between the two groups ( P > 0. 05 ) . Values of arterial carbon dioxide tension ( PaCO2 ) , mean arterial pressure and central venous pressure at 10 min and 25 min after pneumoperitoneum establish-ment were significantly higher than those at 5 min before pneumoperitoneum establishment in two groups (P<0. 05), and the values in low pneumoperitoneum pressure group were significantly lower than those in high pneumoperitoneum pressure group (P<0. 05). Total bilirubin, alanine aminotransferase and aspartate aminotransferase levels at 1 d and 3 d after surgery were significantly higher than those before surgery in two groups (P<0. 05), and the levels in low pneumoperito-neum pressure group were significantly lower than those in high pneumoperitoneum pressure group (P<0. 05). The inci-dence rate of complications in low pneumoperitoneum pressure group was significantly lower than that in high pneumoper-itoneum pressure group (P<0. 05). Conclusion Patients undergoing laparoscopic cholecystectomy combined with viral hepatitis type have liver damage in themselves and poor tolerance. It is beneficial for patients to reduce the intraoperative pneumoperitoneum pressure.关键词
胆囊切除术,腹腔镜/乙型肝炎/血流动力学/肝功能试验Key words
Cholecystectomy/laparoscopic/Hepatitis B/Hemodynamics/Liver function tests分类
医药卫生引用本文复制引用
刘韬,朱毅东..不同气腹压对行腹腔镜胆囊切除术合并乙型病毒性肝炎患者手术期血流动力学及术后肝功能的影响[J].解放军医药杂志,2017,29(9):92-95,4.基金项目
陕西省卫生科研项目(2011K02-11-01) （2011K02-11-01）
