Changes of pneumoperitoneum pressure in laparoscopic cholecystectomy and its influence on cardiac circulation efficiency
Objective To investigate the clinical effect of changes in pneumoperitoneum pressure on cardiac circulation efficiency in patients undergoing laparoscopic cholecystectomy.Methods From January 2020 to December 2021,100 patients who underwent laparoscopic cholecystectomy in our hospital were selected for study.They were divided into two groups according to the size of pneumoperitoneum pressure.The patients who used 14 mmHg pneumoperitoneum pressure were included in the control group(n=50),and the patients who used 10 mmHg were included in the observation group(n=50).The operation conditions,hemodynamics,arterial respiratory,and circulatory function indexes at different stages of the operation were compared between the two groups.Results There was no significant difference in operation time,pneumoperitoneum time,and intraoperative blood loss between the two groups(P＞0.05).The intestinal exhaust time and feeding time of the observation group were(2.9±0.3)d and(3.5±0.6)d,respectively,which were shorter than those of the control group(4.4± 3.0)d and(4.5±2.8)d(P＜0.05).The mean arterial pressure(MBP),heart rate(HR),and cardiac circulation efficiency(CCE)in the observation group were(89±9)mmHg,(92±10)mmHg,(89±9)mmHg,(106±11)times/min,(114±11)times/min,(103±9)times/min,(-0.43±0.11),(-0.84±0.73),(0.28±0.12),immediately after pneumoperitoneum establishment(T1),15min after pneumoperitoneum establishment(T2)and 30 min after surgery(T3),respectively.All of them were lower than those of control group(94±10)mmHg,(99±10)mmHg,(95±9)mmHg,(112±12)times/min,(122±12)times/min,(110±11)times/min.(-0.61±0.35),(-0.52±0.25),(0.14±0.27)(P＜0.05).The partial pressure of oxygen(PaO2)and partial pressure of carbon dioxide(PaCO2)at T1,T2 and T3 were(340±20)mmHg,(351±21)mmHg,(345±23)mmHg,(35±5)mmHg and(38±5)mmHg,(36±6)mmHg,They were lower than(356±22)mmHg,(364±23)mmHg,(360±24)mmHg,(40±8)mmHg,(42±8)mmHg,(40±7)mmHg in the control group,respectively(P＜0.05).Conclusion The change in pneumoperitoneum pressure will affect the operation effect of patients undergoing laparoscopic cholecystectomy.Compared with high pneumoperitoneum pressure,low pneumoperitoneum pressure has less effect on hemodynamics,CCE,and respiratory and circulatory functions.
Laparoscopic cholecystectomyPneumoperitoneum pressureHemodynamicsCardiac circula-tion efficiencyRespiratory and circulatory function
万方数据
维普
