目的 探讨加温二氧化碳气腹对腹腔镜下肝叶切除术中患者体温的变化及出血量的影响。 方法 选取2018年10月~2019年5月江西省人民医院收治的30 例进行腹腔镜肝叶切除术的患者作为研究对象,采用随机数字表法分为实验组和对照组,每组各15 例。实验组患者采用加温二氧化碳气腹,对照组采用常温二氧化碳气腹。比较两组生命体征和并发症发生情况。 结果 两组患者气腹前,气腹后3 h 和术后0.5、1 h 体温比较,差异无统计学意义(P>0.05)。实验组气腹后0.5、1、2 h 和放气后5 min、术后1 h 体温高于对照组,差异有统计学意义(P<0.05)。实验组术中出血量少于对照组,差异有统计学意义(P<0.05)。实验组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论 对腹腔镜下肝叶切除术的患者采用加温二氧化碳气腹,可帮助患者改善体温,减少术中出血量及不良反应,具有一定的推广价值。
Objective To explore the effect of warming carbon dioxide pneumoperitoneum on the changes of body temperature and blood loss in patients undergoing laparoscopic hepatolobectomy.Methods A total of 30 patients with laparoscopic hepatectomy admitted to Jiangxi Provincial People′s Hospital from October 2018 to may 2019 were selected as subjects and divided into experimental group and control group by the random number table method, with 15 cases in each group.Patients in the experimental group were treated with heated carbon dioxide pneumoperitoneum and the control group were treated with normal temperature carbon dioxide pneumoperitoneum.The vital signs and complications of the two groups were compared.Results There was no significant difference in body temperature between the two groups before pneumoperitoneum, three hours after pneumoperitoneum, half an hour after operation and one hour after operation (P>0.05).The body temperature of the experimental group at half an hour after pneumoperitoneum, one hour after pneumoperitoneum, two hours after pneumoperitoneum, five minutes after deflation and one hour after operation in the experimental group were higher than those in the control group, and the differences were statistically significant (P<0.05).The amount of intraoperative bleeding in the experimental group was less than that in the control group,and the difference was statistically significant (P<0.05).The total incidence of complications in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05).Conclusion The use of warming carbon dioxide pneumoperitoneum for patients undergoing laparoscopic hepatectomy can help patients improve their body temperature, reduce intraoperative bleeding and adverse reactions, and has certain promotion value.
Frey JM,Janson M,Svanfeldt M,et al.Inteaoperative local in sufflation of warmed humidifiied CO2incerases open wound and core temperatures:a randomdzed clinical trial[J].World J Surg,2012,36(11):2567-2575.