| Objective:In gynecological laparoscopic surgery,using the special device for heating and humidification of CO2 gas may carried out different influence,According to the current literature reports,The purpose of this study was to apply Meta analysis analyze the influence of different temperature and humidity CO2 in gynecological laparoscopic surgery on body temperature,pain,use of postoperative analgesic drugs,operation time,hospitalization days,etc.Methods: We searched the English databases of Pubmed,Cochrane,Embase,Medline,Web of science,Clinicaltrial.govect,other chinese databases such as Wanfang,CNKI,VIP,etc.Manual all kinds of Journal of Obstetrics and gynecology in Southwest Medical University Library.The limited time was up to the end of December 2015,and the search language was only in English and Chinese.Collect the randomized controlled clinical trial related to gynecological laparoscopic surgery and heated or warmed and humidity of CO2.The literature was screened in accordance with the inclusion criteria and exclusion criteria strictly.Comprehensive meta analysis software was used for statistical analysis.The patients undergoing gynecological laparoscopic surgery are the main objects of study.The effect of co2 infusion at different te m pe r a t ur e an d hum i di t y on th e ope r a t i o n wa s ev a l u a t e d.Results:A total of 17 clinical experimental articles met the criteria and were included in this study.They were all published in English,Including 1160 patients.The clinical features of all the patients were collected as far as possible,such as age,operation time,etc.The results showed that dryness and hypothermia(room temperature)carbon dioxide gas may lead to peritoneal injury,postoperative pain,intraoperative hypothermia and postoperative pelvic adhesions.The use of heating and humidifying CO2 in gynecological laparoscopic surgery can maintain the patient's temperature during operation[SMD = 0.27(0.09,0.46),I2 = 13.4%,P =0.004].lower the pain score from 0 to 8 hours after operation[SMD=-0.23(-0.43;-0.03),I2=35.6%,P=0.028],The difference was statistically significant(P<0.05).But,the improvement is not obvious for postoperative body temperature[SMD = 0.44(-0.22,1.10),I2= 90.7%,P =0.189],Pain score 1-2 days after operation[the first day SMD =-0.08(-0.32,0.17),I2 = 60.2%,P =0.548;the second day SMD =-0.06(-0.35,0.23),I2=60.5%,P =0.681],Anesthesia recovery time[SMD =-0.22(-0.47,0.04),I2=55.5%,P =0.094],Postoperative morphine daily dose[ postoperative day SMD =-0.15(-0.36,0.06),I2=41.8%,P=0.152;the first day SMD =-0.18(-0.39,0.03),I2=24.3%,P =0.090;the second day SMD =-0.10(-0.27,0.07),I2 =0.0%,P =0.234],length of stay[SMD =-0.05(-0.24,0.14),I2 =11.7%,P =0.622],there had no significant difference(P>0.05).Conclusions: Heating and humidifying CO2 pneumoperitoneum can relieve postoperative pain and raise body temperature during operation.Whether it affects the use of postoperative analgesic drugs,leads to postoperative hypothermia,and shortens hospital stay,prevent endoscope lens from fogging and shorten the operation time was not yet unknown.More clinical studies are needed to confirm the effect of heating and humidifying CO2 pneumoperitoneum on gynecologic laparoscopic surgery. |
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