摘要
目的:对比腔镜甲状腺手术中应用低流量气腹和中流量气腹的效果。方法:选择2017年6月-2020年1月在本院行腔镜甲状腺手术的患者80例。根据盲抽法将其分为低流量组和中流量组,各40例。低流量组CO2气腹条件为气流量1.0 L/min,中流量组CO2气腹条件为气流量2.0 L/min。分别于麻醉后10 min(T0)、CO2充气后10 min(T1)、CO2充气后40 min(T2)及术后20 min(T3)时刻测量两组白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)、中心静脉压(CVP)及颈内静脉压力。结果:T0时刻,两组的炎症指标水平、CVP及颈内静脉压力比较,差异均无统计学意义(P>0.05);与T0时刻相比,T1~T3时刻的IL-6、IL-10、TNF-α水平均升高,差异均有统计学意义(P<0.05);在T2时刻,低流量组的IL-6、TNF-α水平均较中流量组低,IL-10水平较中流量组高,差异均有统计学意义(P<0.05)。与T0时刻相比,T1、T2时刻的CVP及颈内静脉压力均升高,差异均有统计学意义(P<0.05);T1~T3时刻,低流量组的CVP及颈内静脉压力均较中流量组高,差异均有统计学意义(P<0.05)。结论:在腔镜甲状腺手术中应用低流量气腹可有效减轻炎症反应,升高CVP及颈内静脉压力,提高手术安全性。
Objective:To compare the effect of low-flow pneumoperitoneum and middle-flow pneumoperitoneum in endoscopic thyroid surgery.Method:Eighty patients who underwent endoscopic thyroid surgery in our hospital from June 2017 to January 2020 were selected.According to the blind drawing method,they were divided into low flow group and medium flow group,with 40 cases in each.The CO2 pneumoperitoneum condition of the low-flow group was an air flow rate of 1.0 L/min;the CO2 pneumoperitoneum condition of the medium-flow group was an air flow rate of 2.0 L/min.The two groups of interleukin-6 (IL-6) and interleukin-6 (IL-6)were measured at 10 min after anesthesia (T0),10 min after CO2 inflation (T1),40 min after CO2 inflation (T2),and 20 min (T3) after surgery.Interleukin-10 (IL-10),tumor necrosis factor alpha (TNF-α),central venous pressure (CVP) and internal jugular vein pressure.Result:At T0,there were no significant differences in inflammatory index level,CVP and internal jugular vein pressure between the two groups (P>0.05).The levels of IL-6,IL-10 and TNF-α at T1-T3 were all higher than those at T0,the differences were statistically significant (P<0.05).At T2,the levels of IL-6 and TNF-α in the low flow group were lower than those in the meddle-flow group,and the levels of IL-10 was higher than that in the meddle-flow group,the differences were statistically significant (P<0.05).Compared with T0,CVP and internal jugular vein pressure at T1 and T2 were significantly increased,the differences were statistically significant(P<0.05).At T1-T3,the CVP and internal jugular vein pressure of the low-flow group were higher than those of the meddle-flow group,the differences were statistically significant (P<0.05).Conclusion:The application of low-flow pneumoperitoneum in laparoscopic thyroid surgery can effectively reduce inflammation,increase CVP and internal jugular vein pressure,and improve surgical safety.
作者
李高峰
曾宪明
甘小海
李明宇
欧阳柳
LI Gaofeng;ZENG Xianming;GAN Xiaohai;LI Mingyu;OUYANG Liu(Qishi Hospital of Dongguan City,Dongguan 523500,China)
出处
《中国医学创新》
CAS
2020年第28期30-33,共4页
Medical Innovation of China
关键词
腔镜甲状腺手术
二氧化碳气腹
炎症反应
中心静脉压
颈内静脉压力
Endoscopic thyroid surgery
Carbon dioxide pneumoperitoneum
Inflammatory response
Central venous pressure
Internal jugular vein pressure
