不同气腹压对腹腔镜胆囊切除术后肩痛的影响

目的探讨腹腔镜胆囊切除手术不同气腹压对术后肩痛的影响。方法于全身麻醉下为100例患者行腹腔镜胆囊切除术,术中气腹压分两组,A组(低气腹压组,50例)气腹压8～9 mmHg,B组(常规气腹压组,50例)气腹压13～14 mmHg,分别记录术后8 h、24 h、48 h肩背部疼痛的人数,并让患者术后8 h、24 h、48 h用疼痛分级(VAS评分法)评分。结果术后A组不同时间段出现肩痛的人数比率明显低于B组,在术后8 h、24 h、48 h,A组患者肩痛的评分均低于B组患者,差异均有统计学意义(P<0.05)。结论腹腔镜胆囊切除术中低气腹压出现肩痛的人数明显较常规气腹压少,且术中低气腹压出现肩痛的程度明显较常规气腹压轻。

Study on effect of different pressure of carbon dioxide pneumopecitoneum on postoperative shoulder pain happened after laparoscopic cholecystectomy

Objective To explore the effect of different pressure of carbon dioxide pneumoperitoneum on postoperative shoulder pain oc- curled following laparoseopic cholecystectomy. Methods Patients admitted in this department of surgery for selective cholecysteetomy were enrolled in this study. These patients were divided into two groups （group A and group B）. In group A （n = 50） , patients were operated under low pressure pneumoperitaneum （8 -9 mmHg）. In group B （n = 50） , patients were operated under standard pressure pneumoperitoneum （13 -14 mmHg）. Postoperative shoulder pain was assessed at 8h, 24 h and 48 h by the Visual Analogue scale of pain. Results The number of postopera- tive shoulder pain in group A is less than group B, and the mean intensity of postoperative shoulder pain in group A was less than that of group B. Conclusion Low pressure laparoseopie choleeystectomy can significantly decrease the frequency and intensity of postoperative shoulder pain com- pared to standard pressure pneumoperitoneum