天津医药

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气腹预处理在家兔气腹模型中减轻肺损伤作用的研究

包延丽1,宁加娟2,李雪梅2   

  1. 1. 广西壮族自治区人民医院麻醉科
    2. 广西壮族自治区人民医院
  • 收稿日期:2010-05-07 修回日期:2010-10-09 出版日期:2011-06-15 发布日期:2011-06-15
  • 通讯作者: 包延丽

The Effect of Laparoscopic Preconditioning Against Laparoscopy-induced Lung Injury in Rabbits.

  • Received:2010-05-07 Revised:2010-10-09 Published:2011-06-15 Online:2011-06-15

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摘要： 摘要 目的：探讨预气腹是否减轻长时间腹腔镜气腹造成的肺损伤。方法：以家兔为研究对象随机分为对照组（N组 ，假气腹组）、短时间气腹组(S组，气腹时间小于1小时)、长时间气腹组(L组，气腹时间大于3小时)及气腹预处理组（P组，在3小时的持续气腹前给予5分钟的预气腹和5分钟的放气）。取各组血浆测血浆蛋白含量，分别取肺组织称取湿干重计算肺组织含水量、测定髓过氧化物酶（myleopemxidase ,MPO）含量，取支气管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）离心后测定上清液蛋白含量和沉渣中白细胞，计算肺通透系数（lung permeability index，LPI）。结果：L组肺组织含水量及BALF中白细胞数均大于其他三组（P＜0.01），肺组织MPO活力明显高于S和N组。P组肺组织MPO活力明显高于N组和S组（P＜0.01），但小于L组。结论：大于3小时的较长时间气腹对肺组织造成了损伤，进行气腹预处理可以减轻这种损伤，可能与抑制中性粒细胞在肺内的募集、减轻炎症反应等机制有关。 关键词 气腹 气腹预处理 中性粒细胞 肺损伤 兔

关键词: 气腹, 气腹预处理, 中性粒细胞, 肺损伤, 兔

Abstract: Abstract Objective: Pneumoperitoneum performed to facilitate laparoscopy is associated with splanchnic perfusion, ischemia/reperfusion (I/R) injury, and oxidative stress. The current study evaluated the effect of laparoscopic preconditioning against laparoscopy-induced lung injury. Methods: 40 rabbits were randomly assigned to following groups. The control group(N) was subjected to a sham pneumoperitoneum. The short time group (S)was subjected to 1 hour of pneumoperitoneum. The long time group (L)was subjected to 3 hours of pneumoperitoneum.The laparoscopic preconditioning group(P) was subjected to 5 min of insufflation and 5 min of desufflation followed by 3 hours of pneumoperitoneum. After 20 min of desufflation subsequent to cessation of pneumoperitoneum, blood, lung, and bronchoalveolar lavage fluid(BALF) samples were obtained from every rabbit of the groups.white blood cell(WBC) count in BALF were detennined .The myleopemxidase (MPO) activity and wet to dry weight ratio(W/D)were also measured．Results: lung permeability index(LPI) and WBC count in BALF of group (L) are higher than the other three groups(p＜0.01),The lung tissue MPO activity of group (P) is much higher than group(S) and group(N) (p＜0.01),but it is lower than group (L).Conclusion: Lung injury induced by more than 3 hours of pneumoperitoneum is more effective than 1 hour of pneumoperitoneum. laparoscopic preconditioning is one of the ways which can inhibit the accumulation of PMNs in lung tissue，and thus attenuate the inflammatory response induced by more than 3 hours of pneumoperit -oneum rabbit lungs． Key words pneumoperitoneum ;ischemia-reperfusion injury; laparoscopic preconditioning ;lung;rabbit； polymorphonuclear leukocyte

Key words: pneumoperitoneum, laparoscopic preconditioning, polymorphonuclear leukocyte, lung, rabbit