CO_2气腹对慢性肺功能不全兔肺功能影响的实验研究  

Effects of CO_2 pneumoperitoneum on pulmonary functions in rabbits with chronic pulmonary failure:An experimental study

作　　者：晋云[1] 陈训如[1] 

机构地区：[1]成都军区昆明总医院肝胆外科,昆明650032

出　　处：《中国微创外科杂志》2004年第3期260-262,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨腹腔镜手术中建立的CO2 气腹对慢性肺功能不全兔肺功能的影响和损伤机制。　方法　依据随机原则 ,将 5 0只健康雄性日本大耳白兔分为 4组 ,即正常对照组 (N0 :n =5 ,免气腹 ) ,实验对照组 (T0 :n =5 ,免气腹 ) ,10mmHg气腹实验组 (T10 :n =2 0 ,10mmHg气腹 ) ,15mmHg气腹实验组 (T15:n =2 0 ,15mmHg气腹 )。兔肺气肿模型稳定后 ,建CO2 气腹 ,压力为 10mmHg(1 33kPa)和 15mmHg(2 0 0kPa) 2种 ,作用时间 2h。分别在气腹前后各时点通过脉冲振荡法测 4组肺功能 (呼吸总阻力、中心阻力、总气道阻力 )。　结果　兔肺气肿模型稳定后呼吸总阻力、中心阻力、总气道阻力升高。与气腹前相比 ,气腹结束时呼吸总阻力、中心阻力、总气道阻力显著下降 (q =17 82 4 ,P <0 0 5 ;q=6 9 6 4 3,P <0 0 .5 ;q =9 315 ,P <0 0 5 ) ,气腹后 2h表现为各值升至最高 (q=4 8 6 31,P <0 0 5 ;q =10 7 84 2 ,P <0 0 5 ;q =5 7 2 13,P <0 0 5 ) ,此后开始降低 ,气腹后 18h升至比气腹结束时略高状态 (q =2 6 313,P <0 0 5 ;q=73 4 99,P <0 0 5 ;q =2 3 5 4 7,P <0 0 5 )。 15mmHg(2 0 0kPa)压力下变化更为显著。　结论　在CO2 气腹条件下 ,慢性肺功能不全机体易发生血流动力学紊乱和肺通气?Objective To investigate the effects of CO 2 pneumoperitoneum during laparoscopic cholecystectomy (LC) on pulmonary functions in chronic pulmonary failure rabbits and their mechanisms. Methods A total of 50 healthy male rabbits ( oryctolagus cuniculus ) were randomly divided into 4 groups: normal control group (N 0: n=5, no pneumoperitoneum), experimental control group (T 0: n=5, no pneumoperitoneum), 10 mmHg experimental group (T 10 : n=20, 10 mmHg pneumoperitoneum) and 15 mmHg experimental group (T 15 : n=20, 15 mmHg pneumoperitoneum). After the successful establishment of emphysema rabbit models, CO 2 pneumoperitoneum was conducted and maintained for 2 hours at the pressure of 10 mmHg (1.33 kPa) and 15 mmHg (2.00 kPa), respectively. Pulmonary functions (total respiratory resistance, central resistance and total airway resistance) of the 4 groups were measured by pulse oscillation technique before and after the pneumoperitoneum, respectively. Results Total respiratory resistance, central resistance and total airway resistance increased after the establishment of emphysema models. And they decreased at the end of pneumoperitoneum compared with those before pneumoperitoneum ( q=17.824, P<0.05; q=69.643, P<0.05; q=9.315, P<0.05 ). They increased to the maximum at 2 hours following the pneumoperitoneum ( q=48.631, P<0.05;q=107.842, P<0.05;q=57.213, P<0.05) , and then began to reduce gradually to a level slightly above the end-points until 18 hours after the pneumoperitoneum ( q=26.313, P<0.05;q=73.499, P<0.05;q=23.547, P<0.05 ). These changes were much more prominent in the Group T15 than in other groups. Conclusions This study shows that CO 2 pneumoperitoneum may result in hemodynamic disorder, ventilation disturbance and depressed lung compliance under the condition of chronic pulmonary failure. Along with increased CO 2 pneumoperitoneum pressure there is also an aggravation of pulmonary damage.

关 键 词：气腹 呼吸阻力 慢性肺功能不全 动物模型 兔 

分 类 号：R605[医药卫生—外科学]