摘要
目的:观察妇科腹腔镜手术前中后不同时间点血浆中肾上腺髓质素(ADM)和心钠素(ANP)的动态变化规律。方法:选择我院行妇科腹腔镜手术患者47例,用放射免疫方法(RIA)测定麻醉前(T0)、气腹前10 min(T1)、气腹形成后10 min(T2)、30 min(T3)、60 min(T4)及解除气腹后30 min(T5),血浆中ADM和ANP含量。结果:T0与T1时血浆ADM和ANP含量无显著性差异(P>0.05);T2和T3时ADM和ANP含量均比T1降低(P<0.05),随着气腹时间延长,T4时ADM和ANP含量略有升高,但仍显著低于气腹前水平;解除气腹后30 min(T5),恢复到T1水平;ADM和ANP含量的变化具有正相关性(r=0.873,P<0.01)。结论:妇科腹腔镜手术时CO2气腹是引起ADM和ANP降低的主要因素;ADM和ANP降低对心脏内分泌功能的影响明显,心脏疾病和内分泌异常患者行CO2气腹手术要慎重。
Objective：To observe the dynamic changes of the plasma levels of adrenomedullin （ADM） and atrial natriuretic polypeptide （ANP） at different time points during gynecology laparoscopic surgery. Methods： The plasma ADM and ANP levels in 47 patients undergoing gynecology laparoscopic surgery were detected by radio - immunoassay before anesthesia （T0）, 10 min （T1） before pneumoperitoneum, 10 min （T2）, 30 min （T3） and 60 rain （T4） after the formation of pneumoperitoneum, and 30 min （ T5 ） after the cessation of pneumoperitoneum. Results： There were no significant differences in the ADM and ANP levels between TO ang T1 （P 〉 0.05 ）. The plasma ADM and ANP levels in T2 and T3 were significantly lower than those in T1 （P 〈 0.05 ）. The ADM and ANP levels in T4 increased slightly, but was significantly lower than the level of T1, then recovered to T1 levels in 30 min （TS） after the cessation of pneumoperitoneum. There was positive correlation between ADM and ANP at different time points （ r = 0. 873, P 〈 0.01 ）. Conclusion ： The decrease of ADM and ANP is caused mainly by CO2 pneumoperitoneum in laparoscopic surgery, which can significantly affect on endocrine function of the heart. A prudent policy should be adopted for patients with heart disease and endocrine abnormality requiring laparoscopic surgery with CO2 pneumoperitoneum.
出处
《西北国防医学杂志》
CAS
2009年第5期351-353,共3页
Medical Journal of National Defending Forces in Northwest China
关键词
妇科腹腔镜
气腹
肾上腺髓质素
心钠素
Gynecological laparoscope
Pneumoperitoneum
Adrenomedullin
Atrial natriuretic polypeptide
