不同CO2气腹条件对腹腔IL-1β和IL-6的影响

Effect of different CO2 pneumoperitoneum on IL-1β and IL-6 in abdominal cavity

目的探讨不同CO2气腹条件对腹腔IL-1β和IL-6的影响。方法将56只雌性SD大鼠按随机数字表法分成7组，1组为对照组，另6组为气腹组，设定CO2气腹条件为压力0．67kPa，气流量1．01Mmin，时间分别为1、2和3h（C1h、C2h和C3h组），同时设立C8p组（压力1．07kPa，气流量1．01Mmin，时间1h）、C2f组（压力0．67kPa，气流量2．0L／min，时间1h）和C3f组（压力0．67kPa．气流量3．0L／min，时间1h）。实验后12h采集腹腔液．ELISA方法检测IL-1β和IL-6浓度。结果CO2气腹引起腹腔炎性反应，随着气腹时间和气流量的增加，C2h、C3h和C3f组腹腔液IL-1β和IL-6浓度升高，并显著高于C1h组（P〈0．05）。随着压力的增加，IL-1β和IL-6浓度虽然升高，但与C1h组差异无统计学意义（P〉0．05）。结论腹腔炎性反应与CO2气腹时间和气流量有关。但在工作压力范围内．炎性反应与压力无关，腹腔镜手术应在工作压力范围内进行．采用较小的气流量并同时缩短手术时间。

Objective To evaluate the effect of different CO2 pneumoperitonenm on IL-1β and IL-6 in abdominal cavity. Methods Fifty-six female SD rats were randomly divided into seven groups. One group was served as control and the others received CO2 pneumoperitoneum. Pneumoperitoneum was established at 0.67 kPa and 1.0 L/rain gas flow for 1, 2 or 3 h with CO2 （group C1 h, C2 h, and C3 h, respectively）. CO2 pneumoperitoneum was further established at 1.07 kPa and 1.0 L/min gas flow for 1 h （group C8p）, at 0.67 kPa and 2.0 L/min gas flow for 1 h （group C2f）, and at 0.67 kPa and 3.0 L/min gas flow for 1 h （group C3f）. After the procedures, peritoneal fluid was collected to analyze the IL-1β and IL-6 level by ELISA method. Results CO2 pneumoperitoneum caused peritoneal inflammatory reaction. With the increasing of duration and gas flow in CO2 pneumoperitoneum, the concentrations of IL-1β and IL-6 in group C2h, C3h and C3f were higher than those in group Clh （P〈0.05）. On the other hand, the concentrations of IL-1β and IL-6 in peritoneal fluid did not change significantly when pressure was increased （P〉0.05）. Conclusions The inflammatory reaction in abdominal cavity after CO2 pneumoperitoneum may be attributed to duration and gas flow instead of the pressure within the standard pneumoperitoneal working pressures. Surgeons should reduce surgical duration and adopt low-velocity gas flow within normal working pressures in clinical practice.