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目的探讨腹腔镜下肠道肿瘤切除患者气腹相关并发症,并分析相应的对策。方法分别选取2011年5月~2013年4月和2013年5月~2015年4月期间本院收治的腹腔镜下肠道肿瘤切除术患者各237例,分别作为A组和B组。两组患者均行腹腔镜手术,A、B组患者气腹压力分别控制在14~19 mm Hg(1 mm Hg=0.133 k Pa)和9~10 mm Hg。统计两组患者气腹相关并发症发生情况及各类气腹相关并发症发生情况。结果 B组发生气腹相关并发症106例,发生率为44.73%,其中肩部疼痛、恶心呕吐、高碳酸血症发生率分别为18.99%、25.74%、0;A组气腹相关并发症发生234例,发生率为98.73%,其中肩部疼痛、恶心呕吐、高碳酸血症发生率分别为40.93%、57.38%、0.42%;B组患者气腹相关并发症、肩部疼痛、恶心呕吐发生率明显低于A组,差异具有统计学意义(P<0.05)。本研究474例患者共有340例患者出现气腹相关并发症,发生率为71.73%,其中以恶心呕吐最为常见,发生197例,占57.94%,高碳酸血症发生率最低。结论腹腔镜下肠道肿瘤切除患者可以发生多种并发症,其中恶心呕吐、肩部疼痛发生率较高,可以通过降低气腹压力进行预防;高碳酸血症等并发症发生几率较低,但是也要通过适当方法进行预防,以免引起严重后果。
Objective To investigate the pneumoperitoneum-related complications of patients undergoing laparoscopic resection of intestinal tumors and analyze the corresponding countermeasures. Methods A total of 237 patients undergoing laparoscopic bowel tumor resection from May 2011 to April 2013 and from May 2013 to April 2015 were selected as Group A and Group B, respectively. Laparoscopic surgery was performed in both groups. Pneumoperitoneum pressure was controlled at 14 to 19 mm Hg (1 mm Hg=0.133 kPa) and 9 to 10 mm Hg in patients in groups A and B, respectively. The incidence of pneumoperitoneum-related complications and the occurrence of various pneumoperitoneum-related complications were recorded in both groups. Results There were 106 pneumoperitoneum-related complications occurred in group B. The incidence was 44.73%. The incidence of shoulder pain, nausea and vomiting, and hypercapnia were 18.99%, 25.74% and 0 respectively. Pneumoperitve complications occurred in group A. In 234 cases, the incidence was 98.73%. Among them, shoulder pain, nausea, vomiting, and hypercapnia occurred in 40.93%, 57.38%, and 0.42%, respectively; P group suffered from pneumoperitoneum-related complications, shoulder pain, and nausea and vomiting. The rate was significantly lower than that in group A, and the difference was statistically significant (P<0.05). In this study, 474 patients had a total of 340 patients with pneumoperitoneum-related complications, the incidence was 71.73%, of which nausea and vomiting were the most common, 197 cases, accounting for 57.94%, the lowest incidence of hypercapnia. Conclusion There are many complications in patients undergoing laparoscopic resection of intestinal tumors. The incidence of nausea, vomiting and shoulder pain is high. It can be prevented by reducing the pneumoperitoneum pressure; the incidence of complications such as hypercapnia is low, but It should also be prevented through appropriate methods so as not to cause serious consequences.