Clinical Research Of Different Pressure CO₂ Pneumoperitoneum On Gastroeuteric Function In Patients Undergoing Gynecological Laparoscopic Surgery

Objective With the continuous improvement of minimally invasive technology and equipment,laparoscopy has been widely used in the treatment of gynecological diseases with its advantages of small trauma and quick recovery.But at the same time,the complexity and difficulty also increased as a result of the surgery,postoperative gastrointestinal symptoms also increased.That is acordingly,mainly in the laparoscopic surgery in intestinal contents cannot pass caused by abdominal pain,abdominal distension,vomiting,bowel lumen exhaust stop and a series of pathophysiological changes of clinical syndrome in the body.Studied in this paper by observing the comparison of different pressure of CO₂ pneumoperitoneum on the influence of postoperative gastrointestinal function in patients with gynecological laparoscopic surgery,to explore the low pressure CO₂ pneumoperitoneum clinical application in gynecologic laparoscopic surgery,on the premise of guarantee and improve the operation safety,speed the recovery of the patients with postoperative,and can be for clinical anesthesia physician and surgeon in laparoscopic surgery in the management of perioperative provide new ideas and concepts.Methods A total of 120 female patients,aged 30-60 years,ASA physical status?or?,BMI?kg/m²?18.5-28.0,expected pneumoperitoneum time 1-3h.Scheduled for elective gynecological laparoscopic surgery were randomly into three groups?n=40 in each?.The pressure of CO₂ pneumoperitoneum were set at 6-8,9-11and 12-14 mm Hg in group L,group M and group H respectively.All of the patient are detected on an empty stomach of serum concentrations of D-lactic acid 6 hours before operation and after operation.And All of the patients'HR,MAP,pH,PaCO_2,PaO₂,P_Platlat and P_Peakeak were recorded before anesthesia?T₁??before pneumoperitoneum?T₂??1 hour after pneumoperitoneum?T₃?2 hours after pneumoperitoneum?T₄?and 1 hour?T₅?after stopping pneumoperitoneum.Record the time of pneumoperitoneum of three group.Record the time of first flatus,intake and defecation,length of primary hospital stays after operation and cost of hospital admission.The quantity of patients with shoulder pain was written 1 day after operation.Then,calculate the incidence rates of shoulder pain in the three groups.Results Compared with the serum concentrations of D-lactic acid at 6 hours before operation,the after operation's were obviously increased in group three.Compared with group L,the serum concentrations of D-lactic acid at 6 hours after operation were obviously increased in group M and groupH?P<0.05?.Compared with group L,the time of first flatus,intake and defecation,length of primary hospital stays after operation were obviously delayed in group M and group H?P<0.05?.Compared with group L,cost of hospital admissionwere obviously increased in group M and group H?P<0.05?.PaO₂ in three groups was not different at T₁^T₅.Compared with group L,pH at T₃^T₄ was significantly decreased in group M and group H?P<0.05?.Compared with group L,PaCO₂ was significantly increased at T₃^T₅ in group M and group H?P<0.05?.The cases of shoulder pain in the group H were higher than group L 1 day after operation.Conclusion The low pressure of CO₂ pneumoperitoneum can reduce the damage of CO₂ pneumoperitoneum on postoperative gastroeuteric function and avail the recovery of parents'postoperative gastroeuteric function in female patients undergoing gynecological laparoscopic surgery.