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不同CO2气腹压力对超重或肥胖患者Trendelenburg体位腹腔镜全子宫切除术的影响
Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position
- 局解手术学杂志 2025年34卷第2期 页码：150-153
- 作者机构：
1.南京鼓楼医院集团宿迁医院麻醉科，江苏 宿迁 223800
2.徐州医科大学麻醉药理学教研室，江苏 徐州 221004
- 作者简介：
顾克，E-mail：1181031213@qq.com
- 基金信息：国家自然科学基金(30872432);宿迁市科技指导计划(宿科发［2019］69号)
DOI：10.11659/jjssx.04E024121
中图分类号： R614.2纸质出版日期：2025-02-25，
收稿日期：2024-04-24，
- 稿件说明：
移动端阅览
王浩, 顾克, 饶丽华, 等. 不同CO2气腹压力对超重或肥胖患者Trendelenburg体位腹腔镜全子宫切除术的影响[J]. 局解手术学杂志, 2025,34(2):150-153.
WANG HAO, GU KE, RAO LI-HUA, et al. Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 150-153.
王浩, 顾克, 饶丽华, 等. 不同CO2气腹压力对超重或肥胖患者Trendelenburg体位腹腔镜全子宫切除术的影响[J]. 局解手术学杂志, 2025,34(2):150-153. DOI： 10.11659/jjssx.04E024121.
WANG HAO, GU KE, RAO LI-HUA, et al. Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 150-153. DOI： 10.11659/jjssx.04E024121.
摘要
目的
2
探讨术中不同CO
2
气腹压力对超重或肥胖患者Trendelenburg体位腹腔镜下行全子宫切除术的影响。
方法
2
选择腹腔镜下行全子宫切除的超重或肥胖患者88例，按照随机数字表法分为低压组和高压组，每组44例。所有患者术中均以CO
2
为气腹介质，低压组患者CO
2
气腹压力为10 mmH
g，高压组患者CO
2
气腹压力为15 mmHg。比较2组患者的手术相关指标、呼吸指标、鼻咽温和不良反应发生情况。
结果
2
2组患者的手术时间、出血量、术中输液量及脏器损伤、中转开腹手术发生率比较，差异均无统计学意义（
P
>
0.05）；低压组患者麻醉苏醒时间短于高压组（
P
<
0.05）。建立气腹30 min时，高压组患者的气道峰压（Ppeak）和气道平台压（Pplat）均明显高于低压组（
P
<
0.05），肺动态顺应性（Cdyn）明显低于低压组（
P
<
0.05）。在建立气腹60 min和气腹结束时，高压组患者的鼻咽温均显著低于低压组（
P
<
0.05）。高压组术中低体温和寒战反应发生率均明显高于低压组（
P
<
0.05）。
结论
2
相对于使用15 mmHg CO
2
气腹压力Trendelenburg体位行腹腔镜下全子宫切除的超重或肥胖患者，10 mmHg CO
2
气腹压力不会增加手术难度，且患者术中气道压较低、肺顺应性好、不良反应少、苏醒快，还可避免术中体温过低。
Abstract
Objective
2
To explore the effects of different CO
2
pneumoperitoneum pressures during surgery on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position.
Methods
2
A total of 88 overweight or obese patients who underwent laparoscopic panhysterectomy were selected and randomly divided into the low-pressure group and the high-pressure group according to random number table method，with 44 patients in each group. All patients used CO
2
as the pneumoperitoneum medium during surgery，with 10 mmHg of CO
2
pneumoperitoneum pressure in the low-pressure group and 15 mmHg of CO
2
pneumoperitoneum pressure in the high-pressure group. The operation-related indexes，respiratory indicators，nasopharyngeal temperature and adverse reactions of patients were compared between the two groups.
Results
2
There was no significant difference in the surgical time，blood loss，intraoperative infusion volume，incidence of organ injury，and laparotomy rate between the two groups （
P
>
0.05）. The recovery time of anesthesia of patients in the low-pressure group was shorter than that in the high-pressure group （
P
<
0.05）.At 30 minutes after the establishment of pn
eumoperitoneum，the peak airway pressure （Ppeak） and plateau pressure （Pplat） of patients in the high-pressure group were significantly higher than those in the low-pressure group （
P
<
0.05），while the dynamic lung compliance （Cdyn） of patients in the high-pressure group was significantly lower than that in the low-pressure group （
P
<
0.05）.At 60 minutes after the establishment of pneumoperitoneum and the end of pneumoperitoneum， the nasopharyngeal temperature of patients in the high-pressure group were significantly lower than those in the low-pressure group （
P
<
0.05）. The incidences of intraoperative hypothermia and shivering in the high-pressure group were significantly higher than those in the low-pressure group （
P
<
0.05）.
Conclusion
2
Compared with 15 mmHg of CO
2
pneumoperitoneum pressure，10 mmHg of CO
2
pneumoperitoneum pressure on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position does not increase surgical difficulty，and the patients has lower airway pressure，better lung compliance，fewer adverse reactions，and faster recovery，which can also avoid intraoperative hypothermia.
关键词
CO2气腹超重肥胖腹腔镜全子宫切除低体温Trendelenburg体位
Keywords
CO2 pneumoperitoneumoverweightobesitylaparoscopepanhysterectomyhypothermiaTrendelenburg position
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