中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2013年
2期
268-270
,共3页
田虎%张阳德%廖前德%亓玉忠
田虎%張暘德%廖前德%亓玉忠
전호%장양덕%료전덕%기옥충
腹腔镜%气腹%免疫%感染
腹腔鏡%氣腹%免疫%感染
복강경%기복%면역%감염
Laparoscopy%Pneumoperitoneum%Immunization%Infection
目的 观察不同种类气腹对腹腔感染模型大鼠细胞因子及吞噬细胞免疫功能的影响和对感染扩散及细菌移位的影响.方法 Wistar大鼠40只,腹腔注射法建立腹腔感染大鼠模型,随机分为4组:对照组、CO2组、N2组和空气组.接种后12 h,麻醉后腹腔穿刺分别输入实验气体,对照组免气腹,持续30 min.术后24h和48 h,各组分别随机挑选5只大鼠,心脏穿刺取血测定肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-2水平,剖腹抽取腹腔液测定TNF-α水平和吞噬细胞活性.结果 (1)术后24 h,血清TNF-α(μgL)和血清IL-6水平(μg/L) CO2组(0.557±0.064;0.195±0.022)明显低于对照组(0.674±0.069；0.247±0.025)、空气组(0.682±0.068;0.256±0.019)和N2组(0.713±0.072；0.265±0.032) (P ＜0.05).(2)术后24h和48h,血清IL-2(μg/L)和腹腔液TNF-α(μg/L) C02组(1.763 ±0.548,1.694 ±0.519;0.774 ±0.095,0.945±0.089)明显低于对照组(3.332±0.753,3.587±0.764;1.029±0.104,1.253±0.175)、空气组(2.867±0.698,2.904±0.686;0.989±0.091,1.270±0.187)和N2组(3.095±0.712,3.112 ±0.725;1.075 ±0.110,1.353±0.201) (P ＜0.05,P＜0.01).(3)术后24 h和48 h,吞噬细胞的吞噬率和吞噬指数也有类似改变.结论 在腹腔感染情况下,CO2气腹较空气气腹、N2气腹或免气腹技术明显抑制机体体液免疫和吞噬细胞功能,增加了腹腔感染扩散和细菌移位的风险.
目的 觀察不同種類氣腹對腹腔感染模型大鼠細胞因子及吞噬細胞免疫功能的影響和對感染擴散及細菌移位的影響.方法 Wistar大鼠40隻,腹腔註射法建立腹腔感染大鼠模型,隨機分為4組:對照組、CO2組、N2組和空氣組.接種後12 h,痳醉後腹腔穿刺分彆輸入實驗氣體,對照組免氣腹,持續30 min.術後24h和48 h,各組分彆隨機挑選5隻大鼠,心髒穿刺取血測定腫瘤壞死因子(TNF)-α、白細胞介素(IL)-6、IL-2水平,剖腹抽取腹腔液測定TNF-α水平和吞噬細胞活性.結果 (1)術後24 h,血清TNF-α(μgL)和血清IL-6水平(μg/L) CO2組(0.557±0.064;0.195±0.022)明顯低于對照組(0.674±0.069；0.247±0.025)、空氣組(0.682±0.068;0.256±0.019)和N2組(0.713±0.072；0.265±0.032) (P ＜0.05).(2)術後24h和48h,血清IL-2(μg/L)和腹腔液TNF-α(μg/L) C02組(1.763 ±0.548,1.694 ±0.519;0.774 ±0.095,0.945±0.089)明顯低于對照組(3.332±0.753,3.587±0.764;1.029±0.104,1.253±0.175)、空氣組(2.867±0.698,2.904±0.686;0.989±0.091,1.270±0.187)和N2組(3.095±0.712,3.112 ±0.725;1.075 ±0.110,1.353±0.201) (P ＜0.05,P＜0.01).(3)術後24 h和48 h,吞噬細胞的吞噬率和吞噬指數也有類似改變.結論 在腹腔感染情況下,CO2氣腹較空氣氣腹、N2氣腹或免氣腹技術明顯抑製機體體液免疫和吞噬細胞功能,增加瞭腹腔感染擴散和細菌移位的風險.
목적 관찰불동충류기복대복강감염모형대서세포인자급탄서세포면역공능적영향화대감염확산급세균이위적영향.방법 Wistar대서40지,복강주사법건립복강감염대서모형,수궤분위4조:대조조、CO2조、N2조화공기조.접충후12 h,마취후복강천자분별수입실험기체,대조조면기복,지속30 min.술후24h화48 h,각조분별수궤도선5지대서,심장천자취혈측정종류배사인자(TNF)-α、백세포개소(IL)-6、IL-2수평,부복추취복강액측정TNF-α수평화탄서세포활성.결과 (1)술후24 h,혈청TNF-α(μgL)화혈청IL-6수평(μg/L) CO2조(0.557±0.064;0.195±0.022)명현저우대조조(0.674±0.069；0.247±0.025)、공기조(0.682±0.068;0.256±0.019)화N2조(0.713±0.072；0.265±0.032) (P ＜0.05).(2)술후24h화48h,혈청IL-2(μg/L)화복강액TNF-α(μg/L) C02조(1.763 ±0.548,1.694 ±0.519;0.774 ±0.095,0.945±0.089)명현저우대조조(3.332±0.753,3.587±0.764;1.029±0.104,1.253±0.175)、공기조(2.867±0.698,2.904±0.686;0.989±0.091,1.270±0.187)화N2조(3.095±0.712,3.112 ±0.725;1.075 ±0.110,1.353±0.201) (P ＜0.05,P＜0.01).(3)술후24 h화48 h,탄서세포적탄서솔화탄서지수야유유사개변.결론 재복강감염정황하,CO2기복교공기기복、N2기복혹면기복기술명현억제궤체체액면역화탄서세포공능,증가료복강감염확산화세균이위적풍험.
Objective To observe the effect of different pneumoperitoneum gases on cytokine and immunologic function of macrophages,and infection spread and bactrial translocation in a rat abdominal infection model.Methods Forty male Wistar rats were intraperitoneally injected with solution of Escherichia coli and were randomly divided into four groups as follows:control group,CO2 pneumoperitoneum group,air pneumoperitoneum group and nitrogen pneumoperitoneum group.The animals with pneumoperitoneum underwent anterior abdominal puncture with a transfusion apparatus needle followed by peritoneal insufflation with different gases (CO2,air,N2),with 5 mmHg intracavity pressure and speed at 0.2 L/min for 30min.The control animals only underwent anterior abdominal puncture.The procedures were performed 12 h after the injection of the bacterial solution.Blood samples and ascites were collected 24 h and 48 h after the surgical procedures.Blood was collected from cardiac puncture for measurements of tumor necrosis factor (TNF)-α,intedeukin (IL)-6 and IL-2.Ascites were collected for determination of TNF-α and activity of macrophages.Results (1) After 24 h,the serum levels of TNF-α (μg/L) and IL-6 (μg/L) were significantly lower in the CO2 group (0.557 ±0.064; 0.195 ±0.022) than in the control group (0.674 ±0.069;0.247±0.025),air group (0.682 ±0.068; 0.256 ±0.019) and N2 group (0.713 ±0.072; 0.265 ±0.032),P ＜ 0.05 ; (2) After 24 h and 48 h,the serum levels of IL-2 (μg/L) and the ascites levels of TNF-α (μg/L) were statistically lower in the CO2 group (1.763 ± 0.548,1.694 ±0.519; 0.774±0.095,0.945 ± 0.089) than the control group (3.332 ± 0.753,3.587 ± 0.764 ; 1.029 ± 0.104,1.253 ±0.175),air group (2.867 ± 0.698,2.904 ± 0.686 ; 0.989 ± 0.091,1.270 ± 0.187) and N2 group (3.095 ±0.712,3.112 ±0.725; 1.075 ±0.110,1.353 ±0.201),P ＜0.05;P ＜0.01 ; (3) After 24 h and 48 h,the phagocytic rate and the phagocytic index also had a similar change.Conclusion Under condition of preexisting abdominal infection,CO2 pneumoperitoneum statistically suppressed humoral immunity and reduced function of macrophages compared to air pneumoperitoneum,nitrogen pneumoperitoneum and gasless technique,which increased the risk of infection spread and bacteria translocation.
