不同CO2气腹压力对患者血清P物质浓度的影响

摘要

Objective To investigate different carbon dioxidc(CO2) pneumopcritoncum pressure on scrum concentration of substance P in patients undergoing laparoscopic resection of rectal cancer,and possible mechanism of postoperative nausea and vomiting induced (PONV). Methods Forty-five adult patients undergoing laparoscopic resection of colon cancer were randomly divided into 3 groups(n= 15) : 12 mmHg( I group)、15 mmHg ( II group) 和 18 mmHg ( HI group) under general anesthesia. Blood samples were taken before opcration(Tl)、30 min after CO2. Pneumopcritoncum was cstablishcd(T2) 、12 h(T3) and 24 h(T4) after operation for determination of scrum concentration of SP. Postoperative nausea and vomiting were recorded. Results The concentration of SP at the time of T3 and T4 , three groups were higher than baseline valucs(P0.05);3组在术后T3和T4时间点 SP 浓度均升高,和基础值比较差异显著(P<0.01);Ⅲ组在T3和T4时间点SP 浓度较Ⅱ组同时点均显著升高(P<0.01)术后6 h内Ⅲ组恶心呕吐发生率较高,但3组间比较无统计学意义.结论 CO2气腹可使患者术中和术后血清SP浓度升高,可能是术后恶心呕吐高发的原因之一;因此,在保证手术操作的前提下,尽量将气腹压力维持在低水平,以减轻对胃肠活动的影响,降低术后恶心呕吐发生.