动态 CO₂ 气腹压力在机器人辅助腹腔镜下肾部分切除术中的应用

打开文本图片集

中图分类号 R737 R614文献标识码A文章编号 2096-7721（2025）07-1181-06

Abstract Objective： To investigate the application effect of dynamic CO2 pneumoperitoneal pressure in robot-assisted laparoscopicpartialnephrectomy（RALPN），andanalyeitsefectonintraoperativehypothermiaandrenalfunctionofpatints. Methods：70patients whounderwentRALPNat General Hospitalof Xinjiang MilitaryRegionof the ChinesePeople'sLiberation Army from August 2O21 to October 2O24 were selected and divided into the constant group （ n =35，intraoperative constant CO pneumoperitoneum pressure） and the dynamic group （n=35，intraoperative dynamic CO2 pneumoperitoneum pressure）. HR， DBP，SBP， bodytemperature，inflmmatoryarkers （RP，WBC，IL-6），renalfunction（srumcreatinie，urineoutput，bloodrearogn）， liverfunction（ALT，AST）werecompaedbetweenthetwo groups.Results：No signficantdiferences wereobservedinHRatTO （room entry） and T3 （surgery completion）， nor in DBP/SBP at TO，T2 （after renal artery opening），and T3 （ Pγ 0.05）. The dynamic group showed significantly lower HR at T1/T2 but higher DBP/SBP at T1 （P<0.05） . Body temperature of the two groups showed no difference atbaselineorsurgeryinitiation（>O.O5），butthedynamicgroupmaintaindhigher temperaturesatpeumoperitonumiiiatio（0 min，30min，1h），mpoarypeumoperitncsstin，pemoperitosablisnt，ndimedatesrgeryosion （ P <0.05）. Preoperative CRP， WBC，and IL-6 levels of the two groups were comparable （P>0.05） ，while the dynamic group had lower postoperative 24 h levels （ P <0.05）. Renal markers （serum creatinine，urine output， blood urea nitrogen） and liver enzymes （ALT， AST） of the two groups were similar preoperatively （P>0.05） ， while the dynamic group had lower serum creatinine/urea nitrogen and higher urine output at 24 h postoperatively，alongside reduced ALT/AST levels （P<0.05） . Conclusion： Dynamic adjustment of CO 2 pneumoperitonempressreduringRLPNcanstabilieiraoperativemodyamics，iigatepotheia，euatesugicals induced inflammation，and improve postoperative renal and hepatic function.

Key words CO2 Pneumoperitoneum;Robot-assisted Surgery; Partial Nephrectomy; Hypothermia; Renal Function

腹腔镜下肾部分切除术目前已成为治疗早期肾肿瘤的主要术式，且取得了良好效果[-2]。（剩余8747字）