CO2气腹压力、时间对腹腔镜术后肩部疼痛的影响

目的 探讨腹腔镜术后肩部疼痛与CO2气腹压力、时间的关系。方法 经患者知情同意及医院伦理委员会批准,将60例接受腹腔镜手术的患者分为2组,A组（30例）CO2气腹压力设为9 mmHg,B组（30例）CO2气腹压力设为13 mmHg。观察比较2组24 h内肩痛发生率。另选50例分为手术时间在1 h以内的C组及2 h以上的D组,观察比较2组24 h内肩痛发生率。结果 A组24 h内4例患者发生肩痛,占13.3%;B组12例,占40.0%。2组差异有统计学意义（χ^2=5.455,P〈0.05）。C组3例,占14.3%;D组4例,占13.8%。2组差异无统计学意义（χ^2=0.002 54,P〉0.05）。结论 腹腔镜手术后肩部疼痛与CO2气腹产生的张力有关,但与气腹时间长短无明显相关性。

Effect of CO2 pressure and time on shoulder pain induced by laparoscopic surgery

Objective To explore the relationship between shoulder pain and carbon dioxide （CO2 ） pneumoperitoneal pressure and time following laparoscopic surgery. Methods Sixty patients who underwent laparoscopic surgery were randomly divided into group A and group B. The pneumoperitoneal pressure for group A was set at 9 mmHg and that for group B was set at 13 mmHg. Then, incidence rates of shoulder pain in 24 hours were observed and compared between the 2 groups. Another 50 patients were divided into group C （whose surgery time was 1 h） and group D （whose surgery time was 2 h）. Incidence rates of shoulder pain for the latter 2 group in 24 hours were also observed and compared. Results There were 4 cases in group A, accounting for 13.3%, and there were 12 cases in group B, accounting for 40.0% （χ^2 = 5. 455, P 〈 0. 05 ）. Significant differences could be seen, when comparisons were made between the 2 groups. There were 3 cases in group C, accounting for 14.3%, and there were 4 cases in group D, accounting for 13.8% （χ^2= 0. 002 54,P 〉 0.05）. There were no significant differences, when comparisons were made between the 2 groups. Conclusion Shoulder pain after laparoscopic surgery was associated with the tension induced by CO2 pneumoperitoneum, however, there was no obvious correlation between duration of pneumoperitoneum and shoulder pain.