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小儿腹腔镜腹股沟疝修补术中低气腹压与标准气腹压的比较

Comparison of low and standard pneumoperitoneum pressure in laparoscopic pediatric inguinal hernia repair.

作者信息

Chen Liang, Lyu Yunxiao

机构信息

Department of General Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Jun;19(2):249-253. doi: 10.5114/wiitm.2024.138769. Epub 2024 Apr 10.

Abstract

INTRODUCTION

The effectiveness and safety of low pneumoperitoneum in laparoscopic pediatric inguinal hernia repair is unclear and required to explore.

AIM

To evaluate the benefits of low (LPP) vs. standard pneumoperitoneum pressure (SPP) in laparoscopic pediatric inguinal hernia repair.

MATERIAL AND METHODS

We performed a retrospective cohort analysis of patients with pediatric inguinal hernia. The patients were divided into LPP and SPP groups. Anesthesia and postoperative characteristics were analyzed.

RESULTS

We enrolled 169 eligible patients in this study. Anesthesia and postanesthesia care unit times in the LPP group were lower than those in the SPP group (p = 0.00, p = 0.01, respectively). The LPP group had lower values for peak partial pressure of end-tidal carbon dioxide (PCO; mm Hg) (33.37 ±4.09 vs. 36.56 ±4.08), trough PCO (38.33 ±5.04 vs. 40.46 ±4.14), and PCO at the end of surgery (35.29 ±4.59 vs. 38.76 ±4.22). The LPP group required less sufentanil citrate (8.76 ±4.07 ml vs. 18.03 ±16.04 ml) and midazolam (1.56 ±0.45 ml vs 1.79 ±0.59 ml) vs. the SPP group, respectively. There was no significant difference between the groups regarding postoperative complications.

CONCLUSIONS

LPP was associated with shorter anesthesia and postanesthesia care unit times, and lower PCO values compared with SPP. Compared with the SPP group, the LPP group had comparable operation times and postoperative complications. However, long-term outcome studies are needed.

摘要

引言

低气腹压力在小儿腹腔镜腹股沟疝修补术中的有效性和安全性尚不清楚,有待探索。

目的

评估低气腹压力(LPP)与标准气腹压力(SPP)在小儿腹腔镜腹股沟疝修补术中的益处。

材料与方法

我们对小儿腹股沟疝患者进行了一项回顾性队列分析。将患者分为LPP组和SPP组。分析了麻醉和术后特征。

结果

本研究共纳入169例符合条件的患者。LPP组的麻醉和麻醉后监护病房时间均低于SPP组(分别为p = 0.00,p = 0.01)。LPP组的呼气末二氧化碳分压峰值(PCO;mmHg)(33.37±4.09 vs. 36.56±4.08)、谷值PCO(38.33±5.04 vs. 40.46±4.14)以及手术结束时的PCO(35.29±4.59 vs. 38.76±4.22)值均较低。与SPP组相比,LPP组分别需要更少的枸橼酸舒芬太尼(8.76±4.07 ml vs. 18.03±16.04 ml)和咪达唑仑(1.56±0.45 ml vs 1.79±0.59 ml)。两组术后并发症无显著差异。

结论

与SPP相比,LPP与更短的麻醉和麻醉后监护病房时间以及更低的PCO值相关。与SPP组相比,LPP组的手术时间和术后并发症相当。然而,仍需要进行长期结局研究。

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