二氧化碳气腹时血管紧张素醛固酮系统的变化  

Changes of angiotensin-aldosterone system in CO_2 pneumoperitoneum

作　　者：李妍芹[1] 张春贤[1] 冯淑娴[1] 边丽华[1] 刘菁 李娟 

机构地区：[1]兰州军区总医院安宁分院妇产科,甘肃兰州730070 [2]兰州军区司令部门诊部妇产科,甘肃兰州730020

出　　处：《第四军医大学学报》2005年第18期1708-1709,共2页Journal of the Fourth Military Medical University

摘　　要：目的:观察腹腔镜妇科手术中患者在全麻及低CO2气腹压和30°头低脚高体位时,血浆中血管紧张素Ⅰ,Ⅱ(ATⅠ,Ⅱ)和醛固酮(ALD)含量的变化.方法:在气腹前10min,气腹后10,30和60min,解除气腹后10min采静脉血,用放射免疫方法(RIA)测定血浆中ATⅠ,Ⅱ和ALD含量.结果:气腹后10min血浆ATⅠ,Ⅱ和ALD含量均比气腹前升高(P<0.05);气腹后30min,ATⅠ,ALD含量仍比气腹前高(P<0.05),ATⅡ显著升高(P<0.01);气腹后60min,除ATⅠ含量仍高外(P<0.05),其余2种激素含量与气腹前无差异性改变,解除气腹后,3种激素均恢复到气腹前水平(P<0.05).结论:全麻及低气压妇科腹腔镜手术对人体应激系统和生理代谢功能有一定的影响.AIM： To observe the changes of angiotensin Ⅰ （AT Ⅰ ）, angiotensin Ⅱ （AT Ⅱ ） and aldosterone （ALD） levels under general anesthesia for female patients when they were under the low CO2 pneumascos and with the body posture of 30° low head and high feet. METHODS. The AT Ⅰ , Ⅱ and ALD levels of all patients under laparoscopy were observed by RIA respectively at 10 min before in- sufflation, 10 min, 30 min and 60 min after insufflation and 10 min after desufflation. RRSULTS： Compared with preinsufflation, there was no significant changes in the plasma levels of AT Ⅰ , AT Ⅱ and ALD after insufflation （P 〉 0.05）, but 10 min after insufflation, they were higher than those before insufflation （ P 〈 0.05 ）. AT Ⅰ and ALD were still higher 30 min after insufflation than those before insufflation （P〈0.05）. AT Ⅱ rose obviously （P〈0.01）and60 min after insufflation, AT Ⅱ and ALD were not different from those before insufflation, except for AT I （P〈0.05）. After desufflation, they all returned to normal level （P 〈 0.05）. CONCLUSION： General anesthesia and low pressure （ lAP 1.33 - 1.59 ） abdominnoscopy have some effects on the stress system and metabolism.

关 键 词：二氧化碳气腹 血管紧张素醛固酮系统 生理代谢功能 妇科腹腔镜手术 应激系统 

分 类 号：R713[医药卫生—妇产科学]