【摘要】 目的探讨非气腹与低压CO2气腹腹腔镜胆囊切除术在老年患者中的应用价值。方法回顾比较2005年1月～2007年12月年龄>65岁、因慢性结石性胆囊炎接受气腹手术(n=24)和非气腹手术(n=12)的老年患者的临床资料,包括手术时间、住院时间、并发症及合并症的变化等。气腹组CO2压力为8～10mmHg,非气腹组采用人工肋第4代悬吊右侧肋弓。结果2组均在腔镜下完成手术,无中转开腹。手术时间气腹组及非气腹组分别为(46.2±14.8)及(52.4±18.6)min(t=-1.087,P=0.285)。2组术中生命体征平稳,无急性CO2潴留或心血管急性事件发生。住院时间气腹组为(10.5±6.8)d,非气腹组为(8.9±5.5)d(t=0.706,P=0.485)。2组顺利康复出院。随访6～42个月,无并发症发生。结论老年患者接受非气腹腹腔镜胆囊切除术是安全可行的,效果与低压CO2气腹手术相当。更多还原

【Abstract】 Objective To investigate the effects of low-pressure carbon dioxide pneumoperitoneum (CLC) and gasless abdominal distension (GLC) on elderly patients during laparoscopic cholecystectomy. Methods The clinical data,including operation time,hospital stay,surgical complications,and changes of other systems,of 36 elderly patients were analyzed. All the patients were older than 65 years when they received laparoscopic cholecystectomy in our hospital from January 2005 to December 2007. Among the cases,CLC (CO2 pressure:8-10 mm Hg) was used in 24,and GLC was employed in 12. The fourth generation artificial rib lifting apparatus was used for GLC. Results All the procedures were completed by laparoscopy,no patient was converted to open surgery. The operation time of the CLC and GLC groups was (46.2±14.8) min and (52.4±18.6) min respectively (t=-1.087,P=0.285). The vital signs of all the cases were stable during the operation,no carbon dioxide retention or cardiovascular affairs occurred. The hospital stay was (10.5±6.8) d in group CLC and (8.9±5.5) d in group GLC (t=0.706,P=0.485). The patients were followed up for 6 to 42 months,no complications occurred during the period. Conclusions GLC is safe for elderly patients with similar efficacy to that of low-pressure CLC.更多还原