不同压力二氧化碳气腹对兔红细胞流变性和微循环的影响  

Effects of different intraabdominal pressure of carbon dioxide pneumoperitoneum on rheology of red blood cells and microcirculation in rabbits

作　　者：叶占勇[1] 李军[1] 刘合年[1] 徐贵森[1] 刘英海[1] 侯景利[1] 

机构地区：[1]成都军区总医院麻醉科,四川成都610083

出　　处：《中国现代医学杂志》2010年第21期3214-3216,共3页China Journal of Modern Medicine

基　　金：成都军区联勤部医学科研"十一五"计划课题(No:MB07011)

摘　　要：目的研究不同压力二氧化碳气腹对兔红细胞流变性和微循环的影响。方法 18只雌性健康兔按气腹压力随机均分为3组:气腹压0 mmHg(Ⅰ组)、气腹压10 mmHg(Ⅱ组)和气腹压15 mmHg(Ⅲ组)。每组兔均在不同的压力下接受气腹1 h。在二氧化碳气腹前5 min(T0)、二氧化碳气腹后30 min(T1)和二氧化碳气腹后60 min(T2)测定动脉血气分析值和红细胞流变性,监测耳廓微循环的血流量和血流速率并记录在相应时点的上述参数值。结果气腹后30和60 min,Ⅱ组与Ⅰ组比较,PaCO2、红细胞刚性指数和聚集指数显著增加(P<0.05),pH、红细胞变形指数、微循环的血流量和血流速率显著下降(P<0.05),Ⅲ组各参数变化更为显著(P<0.01)。红细胞压积气腹前后无明显变化。结论二氧化碳气腹可使红细胞流变性减弱,微循环的血流量和血流速率下降。【Objective】To study effects of different intraabdominal pressure of carbon dioxide pneumoperitoneum on rheology of red blood cells（RBC） and microcirculation in rabbits.【Methods】 Eighteen female healthy rabbits weighing 2.2 kg to 3.5 kg were randomly and equally divided into three groups based on pneumoperitoneum pressure： 0 mmHg group（groupⅠ）,10 mmHg group（groupⅡ） and 15 mmHg（groupⅢ）.Each group received 1 h pneumoperitoneum under different pressure.Blood samples were taken at 5 minutes before CO2 pneumoperitoneum,at 30 and 60 minutes after pneumoperitoneum for the measurements of arterial blood gas analysis and indexes of rheology of RBC.The volume and velocity of the microcirculation of auricle were continuously monitored;such indexes were recorded at the related time points.【Results】 After pneumoperitoneum for 30 and 60 minutes,PaCO2,the aggregation and rigid indexes of RBC were significantly raised（P 0.05）,while pH,the deformation indexes of RBC and the volume and velocity of the microcirculation were markedly decreased（P 0.05） in groupⅡ compared with those in groupⅠ.Even more significant changes in those indexes were observed in group Ⅲ（P 0.01）.The hematocrit changed little.【Conclusion】 After pneumoperitoneum,rheology of RBC decreases,the volume and velocity of the microcirculation are decreased.

关 键 词：二氧化碳气腹 红细胞流变性 微循环 

分 类 号：R61[医药卫生—外科学] R-332[医药卫生—临床医学]