腹腔镜胆囊切除术与开腹胆囊切除术之间组织氧合的比较性变化。

Comparative changes in tissue oxygenation between laparoscopic and open cholecystectomy.

作者信息

Bablekos George D, Michaelides Stylianos A, Analitis Antonis, Lymperi Maria H, Charalabopoulos Konstantinos A

机构信息

Department of Experimental Physiology, Medical School, Democritous University of Thrace, 68100 Dragana, Alexandroupolis, Greece ; Technological Educational Institute (T.E.I.) of Athens, Agiou Spyridonos 28 Street, 12243 Egaleo, Athens, Greece.

"Sismanogleio" General Hospital, First Thoracic Medicine Department, Sismanogleiou 1 Street, 15126 Maroussi, Athens, Greece.

出版信息

J Clin Med Res. 2015 Apr;7(4):232-41. doi: 10.14740/jocmr2086w. Epub 2015 Feb 9.

DOI:10.14740/jocmr2086w

PMID:25699119

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4330015/

Abstract

BACKGROUND

Previous studies examined the effect of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) on physiological variables of the respiratory system. In this study we compared changes in arterial blood gases-related parameters between LC and OC to assess their comparative influence on gas exchange.

METHODS

We studied 28 patients, operated under identical anesthetic protocol (LC: 18 patients, OC: 10 patients). Measurements were made on the morning before surgery (BS), the second (AS2) and the eighth (AS8) postoperative day. Studied parameters, including alveolar-arterial difference in PO2 ((A-a)DO2) and oxygen content (Oct in vol%), were statistically compared.

RESULTS

On AS2 a greater increase was found in ((A-a)DO2) for the OC compared to LC (4.673 ± 0.966 kPa versus 3.773 ± 1.357 kPa, respectively). Between BS and AS2, Oct in vol% decreased from 17.55 ± 1.90 to 15.69 ± 1.88 in the LC and from 16.99 ± 2.37 to 14.62 ± 2.23 in the OC, whilst a reduction (P = 0.093) between AS2 and AS8 was also found for the open method. Besides, on AS2, SaO2% decrease was greater in OC compared to LC (P = 0.096).

CONCLUSIONS

On AS2, the greater increase in OC-((A-a)DO2) associated with Oct in vol% and SaO2% findings also in OC group suggest that LC might be associated with lower risk for impaired tissue oxygenation.

摘要

背景

以往研究探讨了腹腔镜胆囊切除术（LC）与开腹胆囊切除术（OC）对呼吸系统生理变量的影响。在本研究中，我们比较了LC和OC之间动脉血气相关参数的变化，以评估它们对气体交换的相对影响。

方法

我们研究了28例患者，采用相同的麻醉方案进行手术（LC组：18例患者，OC组：10例患者）。在手术前一天早晨（BS）、术后第二天（AS2）和第八天（AS8）进行测量。对包括肺泡-动脉氧分压差（（A-a）DO2）和氧含量（容积百分比的氧含量（Oct））在内的研究参数进行统计学比较。

结果

与LC组相比，OC组在AS2时（A-a）DO2的升高幅度更大（分别为4.673±0.966kPa和3.773±1.357kPa）。在BS和AS2之间，LC组容积百分比的氧含量（Oct）从17.55±1.90降至15.69±1.88，OC组从16.99±2.37降至14.62±2.23，同时开腹手术方法在AS2和AS8之间也发现有降低（P=0.093）。此外，在ASII时，OC组的血氧饱和度（SaO2）百分比下降幅度大于LC组（P=0.096）。