摘要
目的 研究不同CO2 气腹压力对家兔心肌超微结构的影响。方法 1 8只健康家兔 ,随机分为三组。A组气腹压力 1 0mmHg ,B组 1 5mmHg ,C组 2 0mmHg。用氯胺酮和地西泮肌注麻醉。测定气腹前和气腹后 30、6 0min的MAP、CVP ,HR ,测定同一时点的内皮素 (ET)、洋地黄物质(EDLS)和心肌酶谱。实验结束 ,取左室内壁心肌组织行电镜观察。结果 (1 )血液动力学变化 :三组的HR组内、组间比较均无差异。CVP组内比较 ,三组气腹前与气腹后 30、6 0min ,差异非常显著(P <0 0 1 ) ;组间比较 ,气腹后 30、6 0min ,A组与B组、C组差异显著 (P <0 0 5 ) ,B组与C组间无差异。MAP组内比较 ,C组气腹前与气腹后 6 0min差异显著 (P <0 0 5 ) ;组间比较 ,A组与C组、B组与C组间差异显著 (P <0 0 5 )。 (2 )EDLS :组内组间均无差异 ,但气腹后 30、6 0min时的血浆水平比气腹前增加。 (3)ET :组内组间均无差异 ,但组内比较总体呈下降趋势。 (4 )心肌酶谱 :心肌酶随气腹时间的延长和压力的升高呈上升趋势。乳酸脱氢酶 (LDH) :B组气腹前与气腹后 6 0min比较差异显著 (P <0 0 5 )。天冬氨酸转移酶 (AST) :B组气腹前与气腹后 6 0min比较差异显著 (P <0 0 5 )。 (5 )心肌超微结构的变化 :A、B。
Objective To investigate the effect of different intra abdominal pressure (IAP)of CO 2 on the myocardial ultrastructure in rabbits.Methods Eighteen healthy rabbits were randomly assigned to three groups.The IAP was 10mmHg in group A,15mmHg in group B and 20mmHg in group C.All the rabbits were anesthetized with intramuscular ketamine and diazepam.The parameters of HR,MAP,CVP,ET,EDLS and cardiac enzyme were measured and recorded before,and 30min and 60min after the pneumoperitoneum with pressured CO 2.After the experiment,the cardiac tissue of left ventricle was sampled for the ultramicroscopy.Results (1)Hemodynamic changes:the changes of HR,were not significant within groups and among groups.The CVP changes were significant within groups,and among groups of A and B,and A and C 30min and 60min after the pneumoperitoneum with pressured CO 2 ( P< 0 01).The changes of MAP were significant within group C and among groups of A and C,and B and C 60min after pneumoperitoneum with pressured CO 2( P< 0 05).(2)ET:there was no significant difference among groups but there was a trend of decrease within groups.(3)Cardiac enzyme:it had a trend of increase as IAP increased and sustained in a high level.LDH increased significantly in group B 60min after pneumoperitoneum with pressured CO 2( P< 0 05).AST increased significantly in group B 60min after pneumoperitoneum with pressured CO 2( P< 0 01).(4)Myocardial ultrastructure:it had different damage among groups,mild in group A, moderate in group B and serious in group C.Conclusion IAP could induce the injury on the myocardial ultrastructure. [
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第7期419-421,共3页
Journal of Clinical Anesthesiology
