气腹与肾脏损伤

动物及临床实验均显示气腹可使肾脏血流量减少 ,气腹压力越高 ,这种变化越大 ,由此可引起肾小球滤过率下降、尿量减少、血清血肌苷和尿素氮水平升高等表现。这与气腹导致的肾脏血液流变学改变 ,以及神经内分泌因子、体位变化和气体种类等有关 ,同时缺血再灌注损伤可能是一个不容忽视的因素。提示气腹可导致肾脏功能的改变 ,这种影响是由多重机制参与的并在一定压力范围和持续时间内是可逆的。过高的气腹压或对于肾功能不全的肾脏可能造成更为明显的损害。

Pneumoperitoneum and kidney damage

The pneumoperitoneum may reduce the renal blood flow which was demonstrated both in experimental and clinical research. Greater change could be seen as the pressure of pneumoperitoneum increased,which may induce lower GFR, decrease urine output ,increase the level of plasma Scr?BUN and so on.All these changes were related to the variety of hemodynamics?nerval-endocrine factors releasing?body position and sorts of insufflated gas.Ischemia-reperfusion injury also is an ignorable factor. Pneumoperitoneum may influence the kidney function , which is reversible under certain pressure and operating time,and were concerned with multiple mechanism. More obvious damage to the dysfunctional kidney could occur under high pressure of pneumoperitoneum.