CO_2气腹对慢性肺功能不全兔血气影响的实验研究  

Hemodynamic changes induced by CO_2 pneumoperitoneum in rabbits with emphysema

作　　者：晋云[1] 陈训如[2] 吕耀[2] 

机构地区：[1]第三军医大学 [2]云南成都军区昆明总医院,650032

出　　处：《重庆医学》2004年第6期871-872,共2页Chongqing medicine

摘　　要：目的　本研究主要探讨腹腔镜手术中建立的CO2 气腹对慢性肺功能不全兔动脉血气及肺功能的影响和损伤机制。方法　设正常对照组、实验对照组 (仅插入导气针 )和气腹组 ,气腹组又分为气腹结束时和气腹结束后 2、4、6、1 8h 5个时相点。兔肺气肿模型稳定后 ,施加CO2 气腹 ,压力为 1 0mmHg(1mmHg =0 .1 33kPa)和 1 5mmHg两种 ,作用时间 2h。检测各组及各时相点动脉血pH值、PaCO2 和PaO2 。结果　气腹注入后动脉血气开始变化 ,气腹后 2hpH值、PaO2 降至最低 ,PaCO2 升至最高 ,此后pH值、PaO2 浓度开始升高 ,而PaCO2 浓度开始降低 ,至 1 8h后pH值、PaO2 浓度比气腹结束时稍低 ,PaCO2 浓度则稍高。 1 5mmHg压力下各指标变化则更为显著。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障碍、顺应性降低 ,导致了肺功能的损伤。Objective To investigate the hemodynamic changes induced by CO 2 pneumoperitoneum and possible mechanism in rabbits with emphysema.Methods There set normal control group,experimental group (only inserted with Veress needle) and pneumoperitoneum group,of which the third group was further divided into five time points,ie,0,2,4,6 and 18 hours after pneumoperitoneum stopped.After rabbit models with emphysema were established,the abdominal cavity of these models were gradually insufflated with CO 2 and maintained at the pressure of 10mm Hg and 15mm Hg (1mm Hg=0.133 kPa) respectively for two hours by using close method.We tested blood gas (pH,PaCO 2 and PaO 2) in every time points before and after laparoscopy.Results pH and PaO 2 reduced but PaCO 2 in the arterial blood increased 0 and 2 hours after laparoscopy.Further,pH and PaO 2 increased but PaCO 2 reduced 3,6 and 18 hours after laparoscopy.The changes were more evident in the groups at 15 mm Hg pressure than those at 10 mm Hg pressure.Conclusion Under CO 2 pneumoperitoneum,the animals with emphysema are apt to hemodynamic disorder,pulmonary ventilation dysfunction,decreased compliance and pulmonary function damage.In the meantime,the pulmonary function damage worsens with the pressure of CO 2 pneumoperitoneum.

关 键 词：气腹 人工 血气分析 呼吸功能不全 动物模型 

分 类 号：R656[医药卫生—外科学]