• 成都軍區(qū)昆明總醫(yī)院肝膽外科(昆明650032);

目的 探討CO2氣腹對(duì)動(dòng)脈粥樣硬化兔頸動(dòng)脈血流量的影響及其機(jī)理。 方法 將50只日本大耳白兔按隨機(jī)數(shù)字表法分為正常對(duì)照組(n=13)和動(dòng)脈粥樣硬化組(n=37), 后者根據(jù)氣腹壓的不同〔0、10及15 mm Hg(1 mm Hg=0.133 kPa)〕分為3個(gè)亞組,n分別為12、12及13。通過高脂飲食制作兔動(dòng)脈粥樣硬化模型。采用電磁流量計(jì)檢測實(shí)驗(yàn)兔頸動(dòng)脈血流量變化,生化分析儀行血?dú)夥治觥? 結(jié)果 建立氣腹后(10及15 mm Hg)各時(shí)點(diǎn)兔頸動(dòng)脈血流量均明顯高于0 mm Hg組及正常對(duì)照組(P<0.05),且隨氣腹持續(xù)時(shí)間延長而增加,均明顯高于氣腹前(P<0.05),解除氣腹后30 min雖有下降,但仍高于氣腹前(P<0.05); 其中15 mm Hg組頸動(dòng)脈血流量明顯高于10 mm Hg組(P<0.05); 0 mm Hg組與正常對(duì)照組頸動(dòng)脈血流量差異無統(tǒng)計(jì)學(xué)意義(P gt;0.05)。建立氣腹后(10及15 mm Hg)各時(shí)點(diǎn),動(dòng)脈血PaCO2逐漸升高,pH值逐漸下降,均明顯高于或低于氣腹前、0 mm Hg組及正常對(duì)照組(P<0.05); 各時(shí)點(diǎn)0 mm Hg組及正常對(duì)照組 pH值及PaCO2差異無統(tǒng)計(jì)學(xué)意義(P gt;0.05); 各組間及各時(shí)點(diǎn)間血HCO3-含量差異無統(tǒng)計(jì)學(xué)意義(P gt;0.05)。
結(jié)論 動(dòng)脈粥樣硬化狀態(tài)下,CO2氣腹可引起頸動(dòng)脈血流量增加,其機(jī)理可能與腹內(nèi)壓增高、CO2通過腹膜吸收導(dǎo)致PaCO2升高、pH降低、造成高碳酸血癥等原因有關(guān)。

引用本文: 查勇,陳訓(xùn)如,羅丁. CO2 氣腹對(duì)動(dòng)脈粥樣硬化兔頸動(dòng)脈血流量的影響. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(6): 544-547. doi: 復(fù)制

1. 1 汪謙主編.現(xiàn)代醫(yī)學(xué)實(shí)驗(yàn)方法 [M]. 北京: 人民衛(wèi)生出版社,1997955~10822陳訓(xùn)如,田伏洲,黃大熔主編.微創(chuàng)膽道外科手術(shù)學(xué) [M]. 北京: 軍事醫(yī)學(xué)出版社,200079~803Yavuz Y, Ronning K, Lyng O, et al. Effect of increased intraabdominal pressure on cardiac output and tissue blood flow assessed by colorlabeled microspheres in the pig [J]. Surg Endosc, 2001; 15(2)1494Schafer M, Sagesser H, Reichen J, et al. Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats [J]. Surg Endosc, 2001; 15(10)11975Erkan N, Gokmen N, Goktay AY, et al. Effects of CO2 pneumoperitoneum on the basilar artery [J]. Surg Endosc, 2001; 15(8)8066劉春風(fēng),謝紅,吳浩榮,等.二氧化碳?xì)飧箤?duì)腦循環(huán)的影響 [J]. 江蘇醫(yī)藥, 1998; 24(5)3137Halverson A, Buchanan R, Jacobs L, et al. Evaluation of mechanism of increased intracranial pressure with insufflation [J]. Surg Endosc, 1998; 12(3)2668Rosin D, Rosenthal RJ. Adverse hemodynamic effects of intraabdominal pressureis it all in the head? [J]. Int J Surg Investig, 2001; 2(5)3359Josephs LG, EsteMcDonald JR, Birkett DH, et al. Diagnostic laparoscopy increases intracranial pressure [J]. J Trauma, 1994; 36(6)815.
  1. 1. 1 汪謙主編.現(xiàn)代醫(yī)學(xué)實(shí)驗(yàn)方法 [M]. 北京: 人民衛(wèi)生出版社,1997955~10822陳訓(xùn)如,田伏洲,黃大熔主編.微創(chuàng)膽道外科手術(shù)學(xué) [M]. 北京: 軍事醫(yī)學(xué)出版社,200079~803Yavuz Y, Ronning K, Lyng O, et al. Effect of increased intraabdominal pressure on cardiac output and tissue blood flow assessed by colorlabeled microspheres in the pig [J]. Surg Endosc, 2001; 15(2)1494Schafer M, Sagesser H, Reichen J, et al. Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats [J]. Surg Endosc, 2001; 15(10)11975Erkan N, Gokmen N, Goktay AY, et al. Effects of CO2 pneumoperitoneum on the basilar artery [J]. Surg Endosc, 2001; 15(8)8066劉春風(fēng),謝紅,吳浩榮,等.二氧化碳?xì)飧箤?duì)腦循環(huán)的影響 [J]. 江蘇醫(yī)藥, 1998; 24(5)3137Halverson A, Buchanan R, Jacobs L, et al. Evaluation of mechanism of increased intracranial pressure with insufflation [J]. Surg Endosc, 1998; 12(3)2668Rosin D, Rosenthal RJ. Adverse hemodynamic effects of intraabdominal pressureis it all in the head? [J]. Int J Surg Investig, 2001; 2(5)3359Josephs LG, EsteMcDonald JR, Birkett DH, et al. Diagnostic laparoscopy increases intracranial pressure [J]. J Trauma, 1994; 36(6)815.