腹腔镜胆囊切除术中胆囊分破对肺功能的影响

为探讨腹腔镜胆囊切除术中胆囊分破对术后肺功能的影响,作者选择２０例胆囊未破患者（Ａ组）、１０例胆囊分破患者（Ｂ组）和１０例开腹手术患者（Ｃ组）进行研究。结果显示：Ｂ组和Ｃ组术后第１天至第５天或第７天时肺功能指标仍较术前差异有显著意义（Ｐ＜０．０５）,Ａ组仅在术后第１天和术前比较差异有显著性意义（Ｐ＜０．０５）;Ｃ组和Ｂ组二组间比较时肺功能差异无显著意义（Ｐ＞０．０５）;Ａ组与Ｂ、Ｃ组比较手术后第７天时差异仍有显著意义（Ｐ＜０．０５）,Ａ组术后肺功能明显优于Ｂ、Ｃ组。说明术后腹膜炎是术后肺功能下降的又一重要原因,小气道功能也明显下降。在行腹腔镜胆囊切除术过程中应尽量避免分破胆囊或造成出血,以利于患者术后肺功能的恢复,防止术后肺部并发症的发生。

Effects of gallbladder ruptured under laparoscopic cholecystectomy on pulmonary function

To assess effects of gallbladder ruptured and bile running out under laparoscopic cholecystectomy on pulmonary function, we preprospectively studied 20 patients without gallbladder rupture (group A), 10 with gallbladder rupture (group B), and 10 open cholecystectomy (group C). Significant differences were found in the group B and C to all pulmonary function values compared with preoperative values until the 5th to 7th postoperative day (P < 0.05). The group A showed only a significant difference on the first day after operation (P < 0.05). There are no significant differences between groups B and C. Comparing the group A with the group B and C respectively showed a significant differences from the 1st to 7th day (P < 0.05). This study confirms that the group A is superior to the groups B and C. Postoperative peritonitis is also an important cause of pulmonary dysfunction to reduce small airway function. Performing LC, we should try to avoid rupture of gall bladder or hemorrhage to fasten the recovery of patients' pulmonary function and reduce the chance of pulmonary complications.