肺上皮质压力对胆囊切除术后疼痛的影响
1Department of Hepatobiliary and Vascular Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610599, Sichuan Province, China.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|December 3, 2025
概括
腹腔镜胆囊切除术的低压肺管 (8 mmHg) 显著降低了术后疼痛和肝酶升高. 患有高C反应蛋白 (CRP) 的患者可能会从仔细考虑这项技术中受益.
科学领域:
- 最少侵入性的手术
- 手术疼痛管理手术疼痛管理
- 胃肠道手术 胃肠道手术
背景情况:
- 腹腔镜胆囊切除术 (LC) 经常导致显著的术后疼痛.
- 低压肺膜 (8 mmHg) 可能缓解疼痛,但最佳患者选择尚未明确.
研究的目的:
- 为了比较低压 (LPLC) 和标准压 (SPLC) 腹腔镜胆囊切除术之间的术后疼痛结果.
- 为了确定LPLC期间压力转换的预测因素.
主要方法:
- 潜在的随机对照试验涉及200名选择性LC患者.
- 患者被随机分配到8 mmHg (LPLC) 或12 mmHg (SPLC) 的肺皮管.
- 通过面部视觉模拟尺度评估疼痛;进行了手术内参数,恢复和生化标志物的比较. 分析了压力转换的风险因素.
主要成果:
- 12小时后LPLC显著降低了内脏疼痛,48小时后减少了切口疼痛 (p < .05).
- 此外,LPLC还降低了术后的阿斯巴酸胺转移酶 (AST) /氨酸胺转移酶 (ALT) 升高 (p < .05).
- 手术前的C-反应蛋白 (CRP) ≥12.70 mg/L预测的手术内转换从8到12 mmHg (OR 1.053,AUC = 0.704).
结论:
- 低压肺皮管 (8 mmHg) 对LC有效减少术后疼痛和肝功能影响.
- LPLC是安全的和可行的,与SPLC相比.
- 建议LPLC用于手术前CRP≥12.70 mg/L的患者,以最大限度地获得益处.
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
496
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
496
01:24Chronic Pancreatitis I: Introduction
643
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
643
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
782
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
782
01:27Pneumothorax-II
821
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
821
01:29Chronic Pancreatitis II: Collaborative Care
282
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
282
01:22Appendicitis-I: Introduction
2.0K
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
2.0K