Osman Yildirim, Fusun Ayser, Serpil Arikan, Umit Turan, Ebru Menekse, Bulent Unal, Mete Dolapci, Omer Cengiz
Ankara Numune Education and Research Hospital, Ankara, Turkey.
J Pak Med Assoc. 2009 Apr;59(4):201-4.
To examine respiratory functions of patients after open and laparoscopic cholecystectomy and to compare the advantages.
Fifty five cases with cholelithiasis subjected to elective cholescystectomy were studied. The patients were divided into two groups. Open Cholecystectomy (OC) was performed on 27 cases (Group I), and Laparoscopic Cholecystectomy (LC) in 28 cases (Group II). Respiratory function tests were performed 24 hours before the operation and on the 1st and 6th day after surgery. Blood gas values and anaesthesia periods were recorded. Forced expiratuary volume in the 1st second (FEV1), forced vital capacity (FVC) and FEV1/FVC values were also noted.
FEV1, FVC and FEV1/FVC values on first post-operative day in all cases were statistically lower than the preoperative values (p = 0.0001). Percentage changes of respiratory function test was calculated preoperatively and 1st postoperative day. The changes in both groups showed a significant decrease in FEV1, FVC and FEVI/FVC in Group I compared to Group II (p = 0.0001 in FEV1, p = 0.007 in FVC and p = 0.004 in FEV1/FVC). There was no significant difference in respiratory function tests evaluated on the 6th postoperative day and they had returned to normal values. There was no difference among preoperative and postoperative PaCO2, pH values in arteriel blood gas values in all cases (p = 0.355 p = 0,215). These parameters did not differ in both groups (p = 0.527, p = 0.591), There was a significant decrease in PaO2 and O2 saturation in all cases (p = 0.0001), but there was no significant difference when both groups were compared (p = 0.166, p = 0.678).
The better results of pulmonary function tests in patients subjected to LC proves the advantage of the procedure over OC.
检测开腹胆囊切除术和腹腔镜胆囊切除术后患者的呼吸功能，并比较两者的优势。
对55例行择期胆囊切除术的胆结石患者进行研究。将患者分为两组。27例患者行开腹胆囊切除术（I组），28例患者行腹腔镜胆囊切除术（II组）。在手术前24小时以及术后第1天和第6天进行呼吸功能测试。记录血气值和麻醉时间。同时记录第1秒用力呼气量（FEV1）、用力肺活量（FVC）以及FEV1/FVC值。
所有患者术后第1天的FEV1、FVC和FEV1/FVC值在统计学上均低于术前值（p = 0.0001）。计算术前和术后第1天呼吸功能测试的百分比变化。与II组相比，I组的FEV1、FVC和FEV1/FVC变化均显著降低（FEV1中p = 0.0001，FVC中p = 0.007，FEV1/FVC中p = 0.004）。术后第6天评估的呼吸功能测试无显著差异，且已恢复至正常水平。所有病例术前和术后动脉血气值中的PaCO2、pH值无差异（p = 0.355，p = 0.215）。两组间这些参数也无差异（p = 0.527，p = 0.591）。所有病例的PaO2和O2饱和度均显著降低（p = 0.0001），但两组比较无显著差异（p = 0.166，p = 0.678）。
接受腹腔镜胆囊切除术患者的肺功能测试结果更好，证明了该手术相对于开腹胆囊切除术的优势。
