非气腹状态和气腹状态时肝、脾联合伤后兔肝脏表面血流量与肝功能的相关性研究

Eeffects of gasless laparoscopic states and CO_2 pneumoperitoneum states on correlate of hepatic function and hepatic blood flow to combined liver-spleen wound in rabbits

目的探讨肝、脾联合伤后在非气腹状态和气腹状态下兔肝功能(hepatic function,HF)与肝血流量(hepatic blood flow,HBF)的变化的关系,了解非气腹状态下对肝脏的影响。方法制作肝、脾联合伤兔模型,用随机数字表分为6组。观察伤后0.5、1、2.5、3h4个点谷草转氨酶(aspartate aminotransferase,AST)和谷丙转氨酶(alanine aminotransferase,ALT)的变化,并应用八道生理记录仪(多普勒血流量)检测HBF的变化。结果气腹状态下气腹压力越高肝脏表面的血流量降低越明显,AST和ALT的较创伤前升高也越明显(P<0.05),两者成正相关,非气腹状态下血流改变不显著(P>0.05)。结论非气腹状态比气腹状态对肝脏血流量的影响更小,从而肝功能损害也越小。气腹压力导致肝脏血流量的改变,其与肝功能损害呈正相关。

Objective To investigate the change of hepatic function（HF） and hepatic blood flow（HBF）under gasless laparoscopic states and CO2 pneumoperitoneum states to combined liver-spleen wound in rabbits,to investigate their correlate.Methods 48 New Zealand rabbits were randomized into 6 groups according to the intra-abdominal press-ures（IAP）.After achievement of combined liver-spleen wound model,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）,HBF were observed at time of wound,0.5hour after wound,2 hours after wound and 2.5 hours after wound.Results AST and ALT of the group of CO2 pneumoperitoneum states statistically increased than the group of CO2 pneumoperitoneum.And HBF of the group of CO2 pneumoperitoneum states statistically decreased than the group of gasless laparoscopic states.And their correlate is positive correlation ,is statistically in the group of CO2 Pneumoperitoneum.Conclusion The disturbance of the HF and HBF of rabbits the group of gasless laparos-copic states in rabbits is significantly lower than the group of CO2 pneumoperitoneum.