改良密闭排烟气法在腹腔镜胆囊切除手术患者的应用效果

doi:10.16460/j.issn1008-9969.2019.22.071

摘要/Abstract

摘要： 目的探讨改良密闭排烟气法在腹腔镜胆囊切除手术患者中的应用效果。方法选取50例腹腔镜下胆囊切除手术患者,按随机数字表法分成观察组和对照组,每组各25例。观察组采用改良密闭排烟气法,对照组采用传统、开放间断的排烟气法,比较2组患者手术切割开始及腹腔内胆囊切除止血完毕在4个指标间的差异,即碳氧血红蛋白（COHb）的浓度;COHb浓度≥10%发生率;相同时间段（1 h）腹腔镜镜面清晰度（即排气孔放气的次数和碘伏擦拭目镜的次数）及手术时间。结果腹腔内胆囊切除止血完毕,观察组COHb浓度低于对照组（P<0.01）,COHb浓度≥10%发生率低于对照组（P<0.01）;观察组排气孔放气次数及碘伏擦拭目镜次数少于对照组（P<0.01),手术时间短于对照组（P<0.01)。结论对腹腔镜胆囊切除手术患者,使用改良密闭排烟气法排除手术烟气可减少烟气对患者的危害,增加腹腔镜镜面清晰度,缩短手术时间。

关键词: 胆囊切除术, 腹腔镜, 密闭排烟, 碳氧血红蛋白, 手术时间

Abstract: Objective To investigate the effect of modified closed smoke exhaust method in patients undergoing laparoscopic cholecystectomy. Methods Fifty cases with laparoscopic cholecystectomy were divided into observation group and control group according to random number table method, with 25 cases in each group. The observation group was treated with modified closed smoke exhaust method, while the control group with traditional interval open exhaust method. The concentration of carboxyhemoglobin (COHb) at the beginning and the end of intraperitoneal cholecystectomy, the incidence of COHb concentration≥10%, clarity of laparoscopy (i.e. the number of exhaust holes and the number of wiping eyepieces with iodophor) in the same period (1h) and operation time were compared between the two groups. Results After intraperitoneal cholecystectomy and hemostasis thoroughly, the concentration of COHb and the incidence of COHb concentration≥10% in the observation group were lower than those in the control group (P<0.01); the number of exhaust holes and iodophor eyepiece wiping in the observation group was less than that in the control group (P<0.01), and the operation time was shorter than that in the control group (P<0.01). Conclusion For patients undergoing laparoscopic cholecystectomy, modified closed smoke exhaust method can reduce the harm of smoke to patients, increase the clarity of laparoscopy and shorten operation time.

Key words: cholecystectomy, laparoscopy, closed smoke exhaust, carboxyhemoglobin, operation time

中图分类号:

R472.3

罗俊青, 练敏, 陈海奕, 唐翠明, 徐洁, 梁莉莉, 李淑芩. 改良密闭排烟气法在腹腔镜胆囊切除手术患者的应用效果[J]. 护理学报, 2019, 26(22): 71-74.

LUO Jun-qing, LIAN Min, CHEN Hai-yi, TANG Cui-ming, XU Jie, LIANG Li-li, LI Shu-qin. Effect of Modified Closed Smoke Exhaust Method in Laparoscopic Cholecystectomy[J]. Journal of Nursing, 2019, 26(22): 71-74.

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