氣胸可以是腹腔鏡手術的並發症之一，發生率0.2% to 1.9%， 中英文獻見內

看了hs7880網友的貼，google了一下，見到以下文獻：氣胸可以是腹腔鏡手術的並發症之一，發生率0.2% to 1.9%。  腹腔鏡手術時間過長，病人自身情況，當然還有其他各種原因，都可以引起氣胸的。英文文獻後麵還有另外兩篇文獻的信息。其他網友已提到麻醉，自發也可以有氣胸的。另外，好像任何腹腔鏡手術， 不一定婦科手術都可以有氣胸並發症的。

http://bbs.wenxuecity.com/health/578042.html

http://www.xuehuile.com/thesis/d8a1e6857a7f4681b668e21341dc5857.html

婦科腹腔鏡手術並發症37例診治分析
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並發症種類主要為血管損傷，皮下氣腫及氣胸，皮下出血和術中出血、腸管損傷、輸尿管損傷、膀胱損傷等。結論：婦科腹腔鏡並發症的發生與手術的難易程度、醫生操作經驗、手術器械完善、手術範圍的選擇等有關，積極預防可減少並發症的發生。

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3.6 氣胸
　　比較少見，如果處理不及時可造成嚴重後果。文獻報道皮下氣腫延伸致縱隔或氣體通過橫膈裂孔時可引起縱隔氣腫，嚴重的皮下氣腫亦 可引起氣胸，導致呼吸循環衰竭，甚至出現休克或心髒驟停，本組1例氣胸術中血氧飽和度下降，最低至53%，後經床頭胸片確診為左側氣胸，立即停止手術，行 胸腔閉式引流，症狀緩解後迅速完成手術。

http://laparoscopy.blogs.com/prevention_management_3/2010/07/complications-of-laparoscopic-gynecologic-surgery.html

Complications of Laparoscopic Gynecologic Surgery

Bulent Berker, MD, Salih Taskin, MD, Elif Aylin Taskin, MD

Subcutaneous emphysema, pneumomediastinum, and pneumothorax may result from preperitoneal insufflation or leakage of CO₂ around the cannula sites. Prolonged operations, higher maximum measured end-tidal CO₂, a greater number of surgical ports, and older patient age increase the risk.

Pneumomediastinum results from migration of preperitoneal gas to the mediastinum. In the presence of a congenital diaphragmatic defect or intraoperative diaphragm injury, pneumomediastinum and pneumothorax may occur. The incidence is 0.2% to 1.9% for pneumothorax/pneumomediastinum.^35,36 Inhalation of 100% O₂ and application of a thorax tube after discharging CO₂ from the peritoneal cavity must be done. Pneumopericardium has been reported to occur in association with pneumomediastinum and subcutaneous emphysema.³⁶

35.    Murdock CM, Wolff AJ, Van Geem T. Risk factors for hypercarbia, subcutaneous emphysema, pneumothorax, and pneumomediastinum during laparoscopy. Obstet Gynecol. 2000;95:704-709.

36.    Kalhan SB, Reaney JA, Collins RL. Pneumomediastinum and subcutaneous emphysema during laparoscopy. Cleve Clin J Med. 1990;57:639-642.