CO_2气腹后慢性肾衰大鼠肾脏急性时相期病理学的改变

ACUTE EFFECT OF CO 2 PNEUMOPERITONEUM AT DIFFERENT PRESSURE ON Scr?BUN AND RENAL HISTOLOGY IN RAT MODEL WITH CHRONIC RENAL FAILURE

目的 :了解慢性肾功能不全状态下不同压力CO2 气腹对肾脏功能影响及肾脏组织学的变化。方法 :建立大鼠 5/6肾切除慢性肾衰模型 ,分别施加 2h 0 .67kPa和 1 .33kPa的CO2 气腹压 ,检测气腹前和解除气腹后即时 ,1 ,4d的血Scr、BUN浓度 ,光镜下观察各时相点残肾组织H -E染色切片的病理学变化。结果气腹后Scr开始升高 ,以 1d时显著 ;1 .33kPa气腹压引起的改变更明显 ,且较对照组差异有统计学意义。 0 .67kPa气腹压作用后组织结构没有变化 ,1 .33kPa的气腹压使得肾脏组织在气腹解除后即时出现被膜下的肾皮质炎细胞浸润 ,1d后消失。结论 :CO2 气腹可引起慢性肾衰肾脏功能改变 。

Objective:To investigate the influence of CO 2 pneumoperitoneum at different pressure on the kidney function and renal histology in rats with chronic renal failure.Methods:CRF rat models established by 5/6 subnephrectomy were exposed to CO 2 pneumoperitoneum at the pressure of 0.67kPa and 1.33kPa. Serum creatine(Scr) and blood urine nitrogen(BUN) was examined on 0 day, 1 day, 4 day after desufflation individually. Histoligic changes of every specimen which stained using hematoxylin-eosin were evaluated by light microscopy.Results:After CO 2 gas was released, the concentration of Scr increased slightly immediatedly, significantly on 1 day. It return to baseline 4 days late. More significantly increase was measured at the pressure of 1.33kPa. No signs of acute histologic changes were detected in 0.67kPa group. However, inflammatory cell infiltrates in submembrane cortex were found on 0 day after 1.33kPa CO 2 pneumoperitoneum desufflation. Conclusion:Renal function in rats with chronic renal failure had been influenced by CO 2 pneumoperitoneum and reversible change also had been found during transient period post operation at the experimental condition in our study. It was possible that acute renal histoligic changes would appear due to kidney cell injury by exorbitant CO 2 pneumoperitoneum.