CAJ | 학술논문

目的探讨在低气腹压下行腹腔镜胆囊切除术的可行性及低气腹压力对转氨酶的影响.方法对首都医科大学大兴区人民医院普外二科2010年1月-2015年4月门诊收治的胆囊结石和慢性非结石性胆囊炎患者共128例行腹腔镜胆囊切除术,按患者住院号尾号单双数分组,尾号为单号者分入常规气压组(A组:12～14mmHg),尾号为双号者分入低气压组(B组:8～10 mmHg),每组64例患者.应用SPSS12.0软件,采用t检验方法分析比较两组患者手术时间及术前1天、术后第1天、2天血清ALT、AST浓度差异.结果两组患者均顺利完成手术.A组平均手术时间(65±6.5) min,B组平均手术时间(61±8.2)min,差异无统计学意义(t=2.212,P=0.976).与A组相比,B组对转氨酶影响较小,两组数据差异有统计学意义(P＜0.05).结论采用低气腹压(8 ～ 10mmHg)下行腹腔镜胆囊切除术是完全可行的,并不延长手术时间,同时有利于减少气腹压对转氨酶的影响,这对于术前转氨酶异常者尤为重要.
목적 탐토재저기복압하행복강경담낭절제술적가행성급저기복압력대전안매적영향.방법 대수도의과대학대흥구인민의원보외이과2010년1월-2015년4월문진수치적담낭결석화만성비결석성담낭염환자공128례행복강경담낭절제술,안환자주원호미호단쌍수분조,미호위단호자분입상규기압조(A조:12～14mmHg),미호위쌍호자분입저기압조(B조:8～10 mmHg),매조64례환자.응용SPSS12.0연건,채용t검험방법분석비교량조환자수술시간급술전1천、술후제1천、2천혈청ALT、AST농도차이.결과 량조환자균순리완성수술.A조평균수술시간(65±6.5) min,B조평균수술시간(61±8.2)min,차이무통계학의의(t=2.212,P=0.976).여A조상비,B조대전안매영향교소,량조수거차이유통계학의의(P＜0.05).결론 채용저기복압(8 ～ 10mmHg)하행복강경담낭절제술시완전가행적,병불연장수술시간,동시유리우감소기복압대전안매적영향,저대우술전전안매이상자우위중요.
Objective To study the feasibility of laparoscopic cholecystectomy in low pneumoperitoneum pres sure and the effct of low pressure pneumoperitoneum on liver enzymes.Methods A total of 128 cases of laparoscopic gallbladder resection for gallbladder stones or chronic acalculous cholecystitis patients came from outpatient of Department of Two General Surgery of Daxing Hospital Affiliated to Capital Medical University from Jan.2010 to Apr.2015.Patients with odd hospital numbers were divided into the conventional pressure group (group A:12-14 mmHg,n =64).Patients with even numbers were divided into the low pressure group (group B:8-10 mmHg,n =64).The venous blood was respectively collected at the first day and second day preoperatively to determine and compare the contents of alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in two groups.The mean and standard deviation of the above indexes and operation time of two group patients are compared.Results All patients were successfully completed surgery.The average operation time of group A was (65 ± 6.5) minutes,and group B was (61 ± 8.2) minutes,and there was no significant difference between the two groups (t =2.212,P =0.976).Compared with the A group,the B group had less effect on the aminotransferase,the data of the two groups were significantly different (P ＜ 0.05).Conclusion Laparoscopic gallbladder resection underwent the low pneumoperitoneal pressure (8-10 mmHg) is safe and feasible,doesnt extend the operation time,and helps to reduce the effect of pneumoperitoneum pressure on transaminase,which is much important for patients with abnormal aminotransferase preoperative.