不同CO2气腹压力对腹腔镜胆囊切除术后肩痛的影响

目的研究不同CO2气腹压力对腹腔镜胆囊切除术(LC术)后肩部疼痛的影响。方法将100例行LC术的患者随机分为两组,每组50例,分别设定气腹压力为1.2kPa(10mmHg)和2kPa(15mmHg)下行LC术。对比两组术后肩部疼痛发生率及程度。结果在1.2kPa下手术组,患者的术后肩部疼痛程度明显低于2kPa手术组,差异有统计学意义(χ2=22.698,P<0.05)。结论LC术后肩部疼痛的主要原因可能与人工气腹张力对膈肌牵拉刺激有关。在10mmHg低压气腹下行LC术,可显著降低LC术后肩部疼痛的发生率及程度。

Effect of different carbon dioxide pneumoperitoneum pressure on postoperative shoulder pain occurrence following laparoscopic cholecystectomy

Objective To study the effects of carbon dioxide (CO-2) pneumoperitoneum pressure on shoulder tip pain after laparoscopic cholecystectomy(LC).Methods 100 patients undergoing LC were randomized into two groups:50 cases were under 1.2?kPa CO-2 pneumoperitoneum pressure,and the other 50 cases under 2?kPa pressure.The incidence and degree of shoulder tip pain after LC was compared.Results The incidence of postoperative shoulder tip pain in 1.2?kPa group was lower than that in 2 kPa group.Conclusion The over-stretching of the superior hepatic ligaments due to CO-2 insufflation are probably the main cause of post LC shoulder tip pain.1.2?kPa CO-2 pneumoperitoneum helps reduce the occurrence of post LC should tip pain.