二氧化碳气腹对腹腔镜下移植肾功能的影响

Effect of CO2 pneumoperitoneum on renal function in rats

目的探讨不同压力CO2气腹对大鼠肾功能的影响,为临床上改善移植后肾功能提供依据。方法选用SD大鼠120只,建立气腹模型,按不同CO2气腹压和不同的CO2气腹作用时间分为0.67 kPa 30 min组、0.67 kPa 60 min组、0.67 kPa 120 min组;1.33 kPa 30 min组、1.33 kPa 60 min组、1.33 kPa 120 min组;2.0 kPa 30 min组、2.0 kPa 60 min组以及2.0 kPa 120 min组,同时设立对照组,各组术后检测血尿素氮、血肌酐、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平。结果随着手术时间的延长以及气腹压力的增加,血肌酐,血尿素氮及尿NAG均逐渐升高,各组差异有统计学意义(P<0.05)。结论随着手术时间延长及气腹压力的增加,肾功能损害逐渐加重。提示临床上实施后腹腔镜活体供肾切取术时应尽量缩短手术时间,降低气腹压力。

Objective To evaluate the effects of different CO2 pneumoperitoneum conditions on renal function in rats and provide experimental evidence for improving renal graft function after transplantation.Methods SD rats were randomized into 10 groups（n=12） and subject to CO2 pneumoperitoneum at different pressures（0.67,1.33 and 2.0 kPa） for 60 or 120 min.Serum urea nitrogen（BUN）,creatinine（Cr） and N-acetyl-β-D-glocosaminidase（NAG） levels were detected after pneumoperitoneum.Results As the pressure and time of pneumoperitoneum increased,the renal function deteriorated gradually,showing significant differences between the groups（P0.05）.Conclusion Increased pressure and prolonged duration of CO2 pneumoperitoneum causes impairment of the renal function,suggesting the necessity of reducing the operative time and lowering the pressure of pneumoperitoneum when harvesting renal graft in living donors.