2种不同工作原理气腹机形成CO_2气腹对大鼠腹膜浅方肌组织超微结构的影响

Effect of Different Types of Pneumoperitoneum on the Ultrastructure of the Extraperitoneal Muscular Tissues in Rat

目的探讨不同充气方式形成CO2气腹对大鼠腹膜浅方肌组织超微结构的影响。方法选择脉冲式和恒压变流式2种不同工作原理的气腹机分别对2组各40只大鼠腹腔进行CO2充气,设定气腹压力15mmHg,在充气后60、90、120和180min时分别取10只大鼠腹膜浅方横纹肌组织,用透射电镜方法观察气腹作用后大鼠腹膜浅方肌组织超微结构的变化。对照组10只大鼠,仅行麻醉。结果2组大鼠在气腹后60min即在腹膜浅方肌细胞中出现空泡变性,随气腹作用时间延长而越发显著。上述变化在脉冲式气腹机充气组更为明显。180min后脉冲式气腹机组肌细胞出现明显增宽的间隙,肌细胞之间也出现气泡,而恒压气腹机组不明显。结论CO2气腹可以导致大鼠腹膜浅方肌组织损伤,应用恒压气腹机充气可能有助于减少这种损伤。

Objective To investigate the influence of different types of pneumoperitoneum on the ultrastructure of the extraperitoneal muscular tissues in rats. Methods By using pulse-mode or constant-pressure mode insufflators,we established CO2 pneumoperitoneum in 80 rats （40 for each） with the pressure set at 15 mmHg. At 60,90,120 and 180 minutes after the insufflation,the muscular tissues below the peritoneum of the rats （10 rats at each time point） were obtained to observe the ultrastructural change under a transmission electron microscope （TEM）. Ten rats that received anesthesia only were set as a control. Results In both the groups,vacuolar degeneration was found in the myocytes below the peritoneum after 60 minutes of pneumoperitoneum,and became more and more marked with time. Moreover,the phenomenon was more significant in the pulse-mode insufflator group,in which,we observed widened gaps and vacuoles among the myocytes at 180 minutes after the insufflation,while in the other group,such changes were not apparently detected. Conclusions CO2 pneumoperitoneum may injure the muscular tissues below the peritoneum in rats. Constant-pressure mode insufflator is helpful to decrease such an injury.