慢性肾功能衰竭患者二氧化碳气腹下腹腔镜胆囊切除术的临床观察

对15例慢性肾衰竭（CRF）患者分别在10—12mmHg（A组，9例）和13～15mmHg（B组，6例）二氧化碳气腹下行腹腔镜胆囊切除术（LC）。术后A组无明显变化，B组术后第1天尿素氮、血清肌酐水平明显升高，肌酐清除率明显下降，尿量明显减少，与A组比较差异有统计学意义（P〈0．05），1周后恢复至术前水平。提示CRF患者在10～12mmHg气腹下行LC安全，高气腹压可导致肾功能可逆性改变。

Impact of carbon dioxide pneumoperitoneum on laparoseopic cholecystectomy for patients with chronic renal failure

Fifteen patients with chronic renal failure(CRF)underwent laparoscopic cholecystectomy(LC)at carbon dioxide(CO2)pneumoperitoneum pressure of 10-12 mm Hg(Group A,n=9)or 13-15 mm Hg(Group B,n=6).Renal function and urinary volume(UV)of Group A showed no remarkable change following the operation.But in Group B,the levels of blood urine nitrogen(BUN)and serum creatine(Scr)were increased significantly,and creatinine clearance rate(Ccr)and UV were remarkably decreased(P＜0.05).These variants gradually retumed tO the preoperative levels after 1 week.The analysis showed that laparoscopic choleeystectomy at CO2 pneumoperitoneum pressure of 10-12 mm Hg in CRF patients might be safe.Higher CO2 pneumoperitoneum pressure could result in reversible renal Email:yuanhuizhong2000@yahoo.com.cnfunction change.