不同温度CO2气腹对腹腔镜胆囊切除患者术后肺功能和疼痛的影响

目的探讨不同温度二氧化碳（CO2）气腹对腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）患者术后疼痛和肺功能的影响。方法选择我院50名拟做LC术患者，随机分为两组，低体温组（21℃）和等体温组（CO2加温至37℃，WOLF加温气腹机）。测定不同温度CO2气腹LC后肺功能，包括用力肺活量（forced vital Capacity，FVC）、1S用力呼气容积（forced expiratory volume，FEV2）、呼气峰值流量（peak expiratory flow，PEF）、FEV1／FVC比值，及疼痛程度。结果两组患者术后肺功能测定结果均有下降，等体温组术后肺功能的测定结果高于低体温组（P〈0．05）；等体温组术后的疼痛程度较低体温组显著降低（P〈0．05）。结论为了降低术后肺部并发症的发生，腹腔镜手术应采用加温CO2建立气腹。

Influence of Carbon Dioxide Pneumoperitoneum at Different Temperature on Postoperative Pain and Pulmonary Function of Patients undergoing Laparoscopic Cholecystectomy

Objective To investigate the influence of carbon dioxide （COe） pneumoperitoneum at different temperature on postoperative pain and pulmonary function of patients undergoing laparoscopic cholecystectomy （LC）. Methods Fifty patients undergoing LC in our hosptial were randomly divided into 2 groups： hypothermia group（21 ℃）and isothermie group （37℃）. Pulmonary function including forced vital capacity （FVC）,forced expiratory volume（FEV1 ）,maximum peak expiratory flow（PEF）,FEV1/FVC and intensity of pain were measured after CO2 pneumoperitoneum at different temperature. Results Postoperative pulmonary ruction of patients decreasesd in two groups,and isothermic temperature group had signiicantly betterr results than hypothermia group（ P〈0.05）. The intensity of pain in isothermic group was significantly lower than that of hypothermia group. Conclusion Pneumoperitoneum with warming isothermic CO2 in LC could reduce the incidence of postoperative pulmonary complications.