腹膜后腹腔镜手术CO_2气腹时肾素-血管紧张素-醛固酮系统的变化

The changes of renin-angiotensin-aldosterone system in CO_2 pneumoperitoneum during retroperitoneal laparoscopic surgery

目的:动态监测腹膜后腹腔镜手术CO2气腹时不同时段肾素(renin,REN)、血管紧张素Ⅱ(angiotensin-Ⅱ,AT-Ⅱ)及醛固酮(aldosterone,ALD)的变化。方法:选择行泌尿外科腹膜后腹腔镜手术的患者20例,分别抽取CO2气腹前10min(T1)、气腹中30min(T2)、气腹中60min(T3)及气腹后60min(T4)各时段静脉血,运用放射免疫法测定血清REN、AT-Ⅱ及ALD含量。结果:REN、AT-Ⅱ及ALD在腹膜后腹腔镜手术CO2气腹的不同时段均有改变,各激素不同时段差异均有统计学意义(P<0.001),表现为T3>T2>T4>T1,T4时各激素水平与T1差异无统计学意义(P>0.05)。结论:腹膜后腹腔镜CO2气腹对肾素-血管紧张素-醛固酮系统有一定影响,但气腹撤除后,可较快恢复正常。

Objective ： To dynamically monitor the changes of renin （ REN ） , angiotensin-Ⅱ （ AT- Ⅱ ）, aldosterone （ ALD ） at different time of CO2 pneumoperitoneum during retroperitoneal laparoscopic surgery. Methods：Twenty patients underwent urinary retroperitoneal laparoscopie surgery. The venous blood were collected at 10min （ T1 ） before insufflation, 30min （ T2 ） and 60min （ T3 ） after insufflalion and 60rain（ T4 ） after exsufflation respectively,and the REN ,AT- Ⅱ and ALD levels of all patients were observed by radioimmunoassay. Results ： All of the hormones changed at various period of CO2 pneumoperitoneum during retroperitoneal laparoscopic surgery. The changes were statistically significant （ P 〈 0. 001 ） and the appearance was T3 〉 T2 〉 Y4 〉 T1. But the differences of T4 and T1 were not statistically significant （ P 〉 0.05 ）. Conclusions ： CO2 pneumoperitoneum during retroperitoneal laparoscopic surgery could affect renin-angiotensin-aldosterone system. The effects would disappear after exsufflation.