CO_2气腹后腹膜超微结构的动态变化

Dynamic alterations of peritoneal ultrastructure after carbon dioxide pneumoperitoneum

目的:探讨CO2气腹后不同时间点腹膜超微结构的动态变化特点。方法:SD大鼠共36只,随机分为对照组及CO2气腹组。对照组大鼠于麻醉后仅脐部插入气腹针,不充入CO2气体。气腹组于麻醉后建立CO2人工气腹(压力12mmHg,充气时间1h),分别于气腹结束后2、6、12、24、48、72、96h及7d分批处死大鼠各4只,剖腹后采集壁层腹膜,于透射电镜(TEM)下观察各腹膜组织超微结构的变化特点。结果:与对照组相比,CO2气腹组各不同时间点腹膜形态学均发生了明显变化。以48～72h最为显著,至7d仍未恢复。结论:CO2气腹明显改变了大鼠腹膜的形态学。这可能与临床CO2气腹后腹腔恶性肿瘤转移、细菌播散、粘连形成等有关。

Objective：To evaluate the effects of CO2 pneumoperitoneum on ultrastructure of peritoneum.Methods：Thirty-six SD rats were randomly separated into 2 groups：control group and CO2 pneumoperitoneum group.Anesthesia was applied to all rats,but control group not insufflation of CO2 gas.A CO2 pneumoperitoneum was applied to 32 rats.After 2、6、12、24、48、72、96 h and 7d of CO2 pneumoperitoneum,four rats were killed each time,and parietal peritoneal samples were resected to investigate the alterations of peritoneal ultrastructure by transmission electron microscopy（TEM）.Results：As compared with the control group,the peritoneal ultrastructure in different phase pneumoperitoneum groups altered obviously.It peaked at 48～72h,and not reversed at 7d.Conclusions：The peritoneal morphology of rats changed obviously after CO2 pneumoperitoneum.This probablely associated with peritoneal malignant tumor metastasis,bacteria dissemination,desmoplasia after CO2 pneumoperitoneum in clinic.