体位和气腹压力对腹腔镜胆囊切除术后肩痛的影响

目的:研究不同气腹压力和上肢体位对腹腔镜胆囊切除术后肩痛的影响。方法:将160例行LC术的患者随机分为4组,每组40例,术中采取头高足低左倾位,A组为上肢外展≥90度、气腹压力13mmHg;B组为上肢外展≥90度、气腹压力7mmHg;C组为上肢外展≤60度、气腹压力13mmHg;D组为上肢外展≤60度、气腹压力7mmHg。比较4组患者术后肩痛的发生率。结果:上肢体位和气腹压力对术后肩痛发生率有统计学意义(P<0.05),低气腹压力及上肢外展程度小的患者术后肩痛发生率低。结论:上肢体位和气腹压力均是LC术后肩痛的影响因素,选择低气腹压并减少上肢外展程度可以有效减少肩痛的发生。

Influence of Surgical Position and Pneumoperitoneum Pressure on Post-operative Shoulder Pain Following Laparoscopic Cholecystectomy

Objective: To study different pneumoperitoneum pressure and arm position on shoulder pain after laparoscopic cholecystectomy influence.Methods:160 cases of LC patients were randomly divided into four groups,each group 40 cases,intraoperative take the head students low leftward,A group for upper limb abduction≥90 degrees,pneumoperitoneum pressure is 13mmHg;B group for upper limb abduction≥ 90 degrees,pneumoperitoneum pressure is 7 mmHg;C group for upper limb abduction ≤60 degree,pneumoperitoneum pressure is 13mmHg;D group for upper limb abduction ≤ 60 degrees,pneumoperitoneum pressure is 7 mmHg.Comparing the four groups of patients with the incidence of postoperative shoulder pain.Results:Upper limb position and pneumoperitoneum pressure on postoperative shoulder pain incidence was statistically significant(P<0.05),low pneumoperitoneal pressure and upper limb abduction degree of postoperative patients with shoulder pain occurs at a low rate.Conclusion:upper limb position and pneumoperitoneum pressure is LC on postoperative shoulder pain factors,selection of low-pressure pneumoperitoneum and reduction in upper limb abduction degree can effectively reduce the occurrence of shoulder pain.