[1]晋云  陈训如.CO2气腹对慢性肺功能不全兔肺功能影响的实验研究[J].中国微创外科杂志,2004,04(3):260-262.
 Jin Yun,Chen Xunru..Effects of CO2 pneumoperitoneum on pulmonary functions in rabbits with chronic pulmonary failure: An experimental study[J].Chinese Journal of Minimally Invasive Surgery,2004,04(3):260-262.
点击复制

CO2气腹对慢性肺功能不全兔肺功能影响的实验研究()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
04
期数:
2004年3期
页码:
260-262
栏目:
基础研究
出版日期:
2004-03-30

文章信息/Info

Title:
Effects of CO2 pneumoperitoneum on pulmonary functions in rabbits with chronic pulmonary failure: An experimental study
作者:
晋云  陈训如
成都军区昆明总医院肝胆外科,昆明,650032
Author(s):
Jin Yun Chen Xunru.
Department ofHepatobiliary Surgery, Kunming GeneralHospital ofChengdu MilitaryArea, Kunming650032, China
关键词:
气腹 呼吸阻力 慢性肺功能不全 动物模型
Keywords:
Pneumoperitoneum Respiratory resistance Chronic pulmonary failure Animal model Rabbit
分类号:
R-332
文献标志码:
A
摘要:
目的探讨腹腔镜手术中建立的CO2气腹对慢性肺功能不全兔肺功能的影响和损伤机制. 方法依据随机原则,将50只健康雄性日本大耳白兔分为4组,即正常对照组(N0:n=5,免气腹),实验对照组(T0:n=5,免气腹),10 mmHg气腹实验组(T10:n=20, 10 mmHg气腹),15 mmHg气腹实验组(T15:n=20, 15 mmHg气腹).兔肺气肿模型稳定后,建CO2气腹,压力为10 mmHg(1.33 kPa)和15 mmHg(2.00 kPa)2种,作用时间2 h.分别在气腹前后各时点通过脉冲振荡法测4组肺功能(呼吸总阻力、中心阻力、总气道阻力). 结果兔肺气肿模型稳定后呼吸总阻力、中心阻力、总气道阻力升高.与气腹前相比,气腹结束时呼吸总阻力、中心阻力、总气道阻力显著下降(q=17.824, P<0.05;q=69.643, P<0.0.5;q=9.315,P<0.05),气腹后2 h表现为各值升至最高(q=48.631,P<0.05;q=107.842,P<0.05;q=57.213, P<0.05),此后开始降低,气腹后18 h升至比气腹结束时略高状态(q=26.313, P<0.05;q=73.499,P<0.05;q=23.547,P<0.05).15 mmHg(2.00 kPa)压力下变化更为显著. 结论在CO2 气腹条件下,慢性肺功能不全机体易发生血流动力学紊乱和肺通气障碍、顺应性降低,导致肺功能损伤,且气腹压力越高损伤越显著.
Abstract:
Objective To investigate the effects of CO2pneumoperitoneum during laparoscopic cholecystectomy (LC) on pulmonary functions in chronic pulmonary failure rabbits and their mechanisms. Methods A total of 50 healthy male rabbits (oryctolagus cuniculus) were randomly divided into 4 groups: normal control group (N0: n=5, no pneumoperitoneum), experimental control group (T0: n=5, no pneumoperitoneum), 10 mmHg experimental group (T10: n=20, 10 mmHg pneumoperitoneum) and 15 mmHg experimental group (T15: n= 20, 15 mmHg pneumoperitoneum). Afterthe successful establishment of emphysema rabbitmodels, CO2pneumoperitoneumwas conducted and maintained for 2 hours at the pressure of 10 mmHg (1·33 kPa) and 15 mmHg (2·00 kPa), respectively. Pulmonary functions (total respiratory resistance, central resistance and total airway resistance) of the 4 groups were measured by pulse oscillation technique before and after the pneumoperitoneum, respectively. Results Total respiratory resistance, central resistance and total airway resistance increased after the establishment of emphysema models. And they decreased at the end of pneumoperitoneum compared with those before pneumoperitoneum (q=17·824, P<0·05; q=69·643, P<0·05; q=9·315, P<0·05). They increased to the maximum at 2 hours following the pneumoperitoneum (q=48·631, P<0·05;q=107·842, P<0·05;q=57·213, P<0·05), and then began to reduce gradually to a level slightly above the end-points until 18 hours after the pneumoperitoneum (q=26·313, P<0·05;q=73·499, P<0·05;q=23·547, P< 0·05). These changes were much more prominent in the Group T15 than in other groups. Conclusions This study shows that CO2 pneumoperitoneum may result in hemodynamic disorder, ventilation disturbance and depressed lung compliance under the condition of chronic pulmonary failure. Along with increased CO2pneumoperitoneum pressure there is also an aggravation of pulmonary damage.

参考文献/References:

[1]施新猷,主编. 现代医学实验动物学. 北京:人民军医出版社,2000. 453-455.
[2]邓家珍. 脉冲振荡肺功能测定的原理及临床应用. 医学综述,2000,6(6): 253-255.
[3]万莉雅, 张琴, 范永琛, 等. 天津市区3-14岁儿童脉冲振荡法呼吸阻抗正常值测定. 中华结核和呼吸杂志, 2002,25(3): 192-195.
[4]Mead J. Mechanic properties of lungs. Physiol Rev,1996,41:281-320.
[5]Edwin KS,Harold AC,Jefferey MD,et al.Genetic epidemiology of severe,early-onset COPD.Am J Respir Crit Care Med,1998,157:1770-1778.
[6]Rauh R, Hemmerling TM, Rist M, et al. Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth,2001,13(5): 361-365.
[7]Andersson L, Lagerstrand L, Thorne A, et al. Effect of CO2 pneumoperitoneum on ventilation-perfusion relationships during laparoscopic cholecystectomy. Acta Anaesthesiol Scand,2002,46(5): 552-560.
[8]Sha M, Ohmura A,Yamada M. Diaphragm function and pulmonary complications after laparoscopic cholecystectomy. Anesthesiology,1991,75(3A): 255-260.

更新日期/Last Update: 2014-05-14