持续腹腔内高压下腹腔筋膜室综合征家兔模型的构建及评价  

Construction and evaluation of abdominal compartment syndrome rabbits under continuous intra-abdominal hypertension

作　　者：单毅[1] 刘玉杰[1] 陈瑞丰 胡媛琴 SHAN Yi;LIU Yu-jie;CHEN Rui-feng;HU Yuan-qin(Department of Emergency Medicine,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心急诊医学科,北京100048

出　　处：《哈尔滨医科大学学报》2021年第5期457-461,共5页Journal of Harbin Medical University

基　　金：军队后勤科研重大项目(AHJ16J004)。

摘　　要：目的构建并评价持续膀胱内压监测建立腹腔内高压(intra-abdominal hypertension, IAH)下腹腔间室综合征(abdominal compartment syndrome, ACS)家兔模型。方法取新西兰家兔24只,通过模拟实验家兔腹腔内注入氮气,形成腹腔内高压建立ACS家兔模型,按照腹腔内压力的不同分为ACS1组(IAP=15 mmHg)和ACS2组(IAP=20 mmHg),假手术家兔为空白对照组,每组8只。观察3组的动脉收缩压、电解质、肝肾功能、动脉血pH值及中心静脉压等指标,并同时监测3组的肝肾功能中的谷丙转氨酶和尿素氮及超氧化物歧化酶(superoxide dismutase, SOD)、丙二醛(malondialdehyde, MDA)和小肠的炎症因子白介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factorα,TNF-α)及白介素-1β(interleukin-1β,IL-1β)的变化。结果监测家兔腹腔内压分别为15 mmHg或20 mmHg均可达到ACS腹腔内压诊断标准。ACS1组和ACS2组血气分析与肝肾功能等病理生理的指标变化相同,差异无统计学意义(P>0.05),两组家兔持续腹腔内高压下血压降低(P<0.05),中心静脉收缩压上升(P<0.05),小肠的炎症因子IL-6、TNF-α及IL-1β增高(P<0.05),长时给予腹腔内高压后血K;升高(P<0.05),血pH值、血Ca;降低(P<0.05);ACS1组和ACS2组差异无统计学意义(P>0.05)。结论向家兔腹腔内注入氮气滴定腹腔内压,将腹腔内压控制在15~20 mmHg,可产生符合ACS的病理生理变化,制成稳定的ACS模型。Objective To investigate and evaluate the effect of continuous intravesical pressure monitoring to establish a rabbit model of abdominal compartment syndrome(ACS) with intra-abdominal hypertension(IAH). Methods A total of 24 New Zealand rabbits were divided into the ACS rabbit models by injecting nitrogen into the abdominal cavity of simulated experimental rabbits to form intra-abdominal high pressure. According to the difference of intra-abdominal pressure, they were divided into ACS1 group(IAP=15 mmHg), ACS2 group(IAP=20 mmHg) and the blank control group(sham operation), with 8 rabbits in each group. The arterial systolic blood pressure, electrolytes, liver and kidney function, blood acid-base and central venous pressure and other indicators were observed, alanine aminotransferase, urea nitrogen superoxide dismutase(SOD), malondialdehyde(MDA) and small intestinal inflammatory factors interleukin-6(IL-6), tumor necrosis factor α(TNF-α) and interleukin-1β(IL-1β) of 3 groups were recorded and compared. Results The intra-abdominal pressure of 2 groups of ACS rabbits were 15 mmHg or 20 mmHg, respectively, which met the diagnostic criteria of ACS intra-abdominal pressure. The blood gas analysis, liver and kidney function of the ACS1 group and the ACS2 group had no significant differences(P>0.05). In rabbits with continuous intra-abdominal hypertension of two groups, blood pressure decreased(P<0.05), central venous pressure increased(P<0.05), and small intestinal inflammatory factors IL-6, TNF-α and IL-1β increased(P<0.05). When intra-abdominal hypertension for a long time, it was found that plasma K;increased(P<0.05) and blood pH value and plasma Ca;decreased(P<0.05). There was no significant difference between ACS1 group and ACS2 group(P>0.05). Conclusion A stable ACS model can be established by injecting nitrogen into the abdominal cavity of rabbits and controlling the intraperitoneal pressure to 15~20 mmHg Which can produceing pathophysiological changesin accord with ACS.

关 键 词：腹腔内高压 腹腔筋膜室综合征 家兔 

分 类 号：R572.2[医药卫生—消化系统]