摘要
目的比较全身麻醉下经腹腔腹膜前腹腔镜腹股沟疝修补术(TAPP)和完全腹膜外腹腔镜腹股沟疝修补术(TEP)对患者呼吸功能的影响。方法选取2015年11月至2017年11月该院收治的行腹腔镜腹股沟疝修补术患者62例,分为TAPP组(30例)和TEP组(32例)。观察两组患者全身麻醉后二氧化碳(CO2)气腹前(TO),气腹后10 min(T1)、30 min(T2)、60 min(T3)、90 min(T4),关气腹后10 min(T5)的呼气末二氧化碳分压(PETCO2)、气道压力(Paw)、脉搏血氧饱和度(SpO2)等临床指标的变化。结果两组患者TO、T5时PETCO2、Paw、SpO2比较,差异均无统计学意义(P>0.05)。两组患者T1时PETCO2与同组T0时比较,差异均有统计学意义(P<0.05),但两组患者T1时PETCO2比较,差异无统计学意义(P>0.05);TAPP组患者T2、T3、T4时PETCO2均明显高于TEP组,差异均有统计学意义(P<0.05)。两组患者T1时Paw与T0比较,差异均有统计学意义(P<0.05);TAPP组患者T1、T2、T3、T4时Paw均明显高于TEP组,差异均有统计学意义(P<0.05)。两组患者T1、T2、T3、T4时SpO2比较,差异均无统计学意义(P>0.05)。结论 TEP对呼吸功能影响较TAPP小,对合并心、肺疾病患者建议选择TEP。
Objective To investigate the effect of laparoscopic transabdominal preperitoneal hernia repair （TAPP） and laparoscopic totally extraperitoneal hernia repair（TEP） on the respiratoi7 function under general anesthesia. Methods A total of 64 patients with laparoscopic inguinal hernia repair in the hospital fl＇om November 2015 to November 2017 were select- ed and divided into the TAPP group （30 cases） and TEP group （32 cases）.The clinical indicators changes of end-tidal C O2（PET CO2） ,Pawand SpO2 before CO2 pneumoperitoneum（T0）,at 10 min （T1）, 30 min （T2）,60 rain （T3）,90 rain （T4） after pneumo- peritoneum and after pneumoperitoneum close after general anesthesia were observed in the two groups. Results PETCO2, Paw and SpO2 at T0,T5 had no statistical differences between the two groups（P〉0.05）. PET CO2 in the two groups had statistical differ- ences between at T1 and To（P〈0.05）, but PET CO2 at T1 had no statistical difference between the two groups （P〉0.05）.PET CO2 at T2, T3 and T4 in the TAPP group were significantly higher than those in the TEP group, the differences were statistically signifieant （P〈0.05）.Paw in the two groups had statistical difference between at T1 and T0 （P〈0,05）.Paw at T1, T2, T3, T4 in the TAPP group were significantly higher than those in the TEP group, the differences were statistically significant （P〈0.05）. SpO2 at T1, T2, T3, T4 had no statistical differences between the two groups （P〉0.05）. Conclusion The effect of TEP on the respiratory function is lower than that of TAPP. It is suggested to choose TEP for the patients with complicating heart and puhnonary disease.
作者
卢永媚
李艳华
刘天啸
刘治昆
LU Yongmei;LI Yanhua;LIU Tianxiao;LIU Zhikun(Department of Anesthesiology,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin,Guangxi 541002,China;Department of Surgery,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin,Guangxi 541002,China)
出处
《现代医药卫生》
2018年第21期3324-3326,共3页
Journal of Modern Medicine & Health
关键词
腹腔镜
疝
腹股沟/外科学
麻醉
全身
二氧化碳
气腹
人工
呼吸功能不全
Laparoscopes
Hernia
inguinal/surgery
Anesthesia
general
Carbon dioxide
Pneumoperitone- um,artificial
Respiratory insufficiency
