摘要
目的:探讨妇科腹腔镜手术后膈下积血对术后肩痛的影响.方法:选取2006-01/2007-01在我科行妇科腹腔镜手术患者182例,在相同的CO2气腹压力(12mmHg,1mmHg=0.133kPa)及相同的体位下进行手术,术后常规探查右侧膈下积血情况;返回病房后,采用国际通用的10分视觉量表法观察患者术后3d内肩痛的发生率、程度及持续时间.结果:182例患者中有78例出现膈下积血,其中术后发生肩痛者为52例(66.7%),而104例膈下无积血的患者,术后发生肩痛者仅有44例(42.3%),两者相比,其差异具有统计学意义.结论:腹腔镜手术后,膈下积血会刺激膈肌,引起患者肩部疼痛,膈下积血是术后肩痛的主要原因之一.
AIM： To investigate the shoulder pain caused by subdiaphragmatic blood accumulation after gynecological laparoscopical operations. METItODS： The 182 patients with gynecological laparoscopical operations from January 2006 to January 2007 were enrolled in this study. All the operation procedures were carried out under the same pneumoperitoneum pressure （ 12 mmHg） and at the same posture. After surgeries, we routinely examined whether the blood accumulated under the diaphragmatic or not, and the volume of the blood loss. The incidence and degree of shoulder pain were evaluated by visual analogue scale （VAS） in three days after surgeries. RESULTS： There were 78 patients who had subdiaphragmatic blood accumulation, among which, the incidence of shoulder pain was 66.7% （52 patients） ; in the other 104 patients who had not subdiaphragmatic blood accumulation, the incidence rate of shoulder pain was 42.3% （44 patients）. The data showed that the shoulder pain was closely correlated with the subdiaphragmatic blood accumulation. CONCLUSION： After laparoscopical operation, the blood under diaphragmatic muscle may stimulate the diaphragmatic muscle, which may result in the shoulder pain of the patients. Subdiaphragmatic blood accumulation may play an important role in shoulder pain after gynecological laparoscopical operation.
出处
《第四军医大学学报》
北大核心
2007年第23期2175-2177,共3页
Journal of the Fourth Military Medical University
关键词
膈下积血
腹腔镜
肩痛
并发症
subdlaphragmatic blood accumulation
laparoscopy
shoulder pain
complication
