二氧化碳气腹对兔眼内压及视网膜和视神经病理变化的影响  

Effect of carbon dioxide pneumoperitoneum on intraocular pressure of rabbit and the pathological changes about optic nerve and retina

作　　者：牛金柱[1] 兰海涛[1] 王卉[1] 赵君[1] 刘庆鑫[1] 蔚鑫 马亚群[2] 

机构地区：[1]解放军第264医院麻醉科,太原030001 [2]北京军区总医院麻醉科,100700

出　　处：《中华临床医师杂志（电子版）》2015年第15期66-68,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的：探讨二氧化碳（CO2）人工气腹对兔眼内压（IOP）及视网膜和视神经组织形态学病理学变化的影响。方法家兔20只随机分为对照组（假手术组）和气腹组。OLYMPUS全自动气腹机建立气腹模型，腹内压力恒定于10 mmHg，分别于麻醉开始前（T0）、气腹3 h（T1）、气腹4 h（T2）、气腹5 h（T3）、气腹6 h（T4）测量眼内压。于相对应的手术时间后取病理进行光镜观察病理改变。结果对照组兔IOP在手术前后比较差异无统计学意义（P＞0.05），气腹组兔气腹后IOP逐渐增高，T1～T4[（22.9±1.37）、（24.5±1.47）、（25.21±1.42）、（25.8±0.67）mmHg]时明显高于T0时[（13.37±2.12）mmHg]，与对照组比较差异有统计学意义（P＜0.05）。光镜观察：气腹组4 h，视网膜视细胞开始逐渐萎缩，细胞出现水肿，退变，并随气腹时间延长细胞逐渐融合，细胞层数变薄。气腹6 h，视网膜局部细胞空泡坏死，细胞排列疏松，融合变性明显，细胞间质也显疏松。柱状细胞出现水肿、萎缩凋亡。视神经病理显示，气腹4 h有炎症细胞浸润，6 h局部细胞空泡坏死，细胞排列疏松，细胞间质也显疏松。结论CO2人工气腹3 h可导致兔IOP升高，随气腹时间延长IOP进一步升高，4 h起引起视网膜和视神经病理损害。ObjectiveTo investigate the effect of carbon dioxide pneumoperitoneum of （CO2） and optic nerve pathological changes of intraocular pressure in rabbits.Methods20 rabbits were randomly divided into control group （sham operation group） and pneumoperitoneum group. Pneumoperitoneum model were built by OLYMPUS automatic pneumoperitoneum machine and pressure were constanted between 10 mmHg, intraocular pressure were recorded before induction of anesthesia （T0）, 3 h after pneumoperitoneum （T1）, 4 h （T2）, 5 h （T3）, 6 h （T4）. In the corresponding time after operation, the pathological change was observed by light microscopy.Results There were no significant difference before and after operation about IOP in control group （P〉0.05）. IOP in pneumoperitoneum group were significantly higher than that of T0 and compared with control group there were significant differences （P〈0.05）. Light microscopy： in pneumoperitoneum group 4 hours later, retinal tal columnar cels began to gradualy atrophic, cels appeared edema and degeneration also prolonged with pneumoperitoneum cels gradualy fusion and the cel layers thiner. After 6 hours, local retinal cels began vacuolating necrosis, cel arranged loosely, interstitial cels also showed osteoporosis. Columnar cels also began edema, apoptosis and atrophy. Optic nerve revealed after 4 hours by pneumoperitoneum, there was inflammatory cel infiltration, 6 hours later, local cels began vacuolating necrosis, cel arranged loosely and stromal cels also showed osteoporosis.Conclusion 3 hours after CO2 pneumoperitoneum, IOP of rabbit increased, 4 hours later the retina and optic nerve appeared pathological damages.

关 键 词：气腹 兔 眼内压 视网膜 病理学 

分 类 号：R614[医药卫生—麻醉学]