气腹预处理在家兔气腹模型中减轻肺损伤作用的研究  

The Effect of Laparoscopic Preconditioning against Laparoscopy-Induced Lung Injury in Rabbits

作　　者：包延丽[1] 宁加娟[1] 李雪梅[1] 

机构地区：[1]广西壮族自治区人民医院麻醉科,530021

出　　处：《天津医药》2011年第6期554-556,共3页Tianjin Medical Journal

基　　金：广西壮族自治区科技厅科学基金资助课题(项目编号:桂科青0728041)

摘　　要：目的:探讨气腹预处理是否可以减轻长时间腹腔镜气腹造成的肺损伤。方法:家兔40只随机分为对照组(N组,假气腹组)、短时间气腹组(S组,气腹时间小于1h)、长时间气腹组(L组,气腹时间大于3h)及气腹预处理组(P组,在3h的持续气腹前给予5min的预气腹和5min的放气)。解除气腹20min后取各组家兔血浆测蛋白含量,取肺组织称取湿、干质量并计算肺组织含水量,测定肺组织髓过氧化物酶(MPO)含量,取支气管肺泡灌洗液(BALF),测上清液蛋白含量和沉渣中白细胞(WBC)计数,计算肺通透系数(LPI)。结果:L组肺组织MPO活力、LPI及BALF中WBC明显高于其他3组(P<0.01),P组肺组织MPO活力及BALF中WBC明显高于N组(P<0.05或P<0.01),肺组织含水量低于L组(P<0.05)。结论:进行气腹预处理可以减轻长时间气腹的肺损伤,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。Objective： To evaluate the effect of laparoscopic preconditioning on laparoscopy-induced lung injury. Methods： Forty 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 h of pneumoperitoneum. The long time group （L） was subjected to 3 h of pneumoperitoneum. The laparoscopic preconditioning group （P） was subjected to 5 min of insufflation and 5 min of deflation followed by 3 h of pneumoperitoneum. After 20 min of deflation subsequent to cessation of pneumoperitoneum, the samples of blood, lung and bronchoalveolar lavage fluid （BALF） were obtained from rabbits of groups. The white blood cell （WBC） count in BALF was determined. The lung permeability index （LPI） was calculated. The myeloperoxidase （MPO） activity, wet to dry weight ratio （W/D） of lung sample and lung water content were also measured. Results： The values of MPO activity, LPI and WBC count in BALF were significantly higher in group （L） than those of other three groups （P 〈 0.01）. The values of MPO activity in lung tissue and WBC count in BALF were significantly higher in group （P） than those of group （N） （P 〈 0.01）, but the lung water content was lower in group （P） than that of group （L） （P 〈 0.05）. Conclusion： Laparoscopic preconditioning can attenuate the injury by inhibiting the accumulation of neutrophil and inflammatory response in rabbit lungs.

关 键 词：气腹 人工 支气管肺泡灌洗液 中性白细胞 肺疾病 创伤和损伤 过氧化物酶 疾病模型 动物 兔 

分 类 号：R619.9[医药卫生—外科学]