不同气腹环境对大鼠系统免疫功能的影响

目的　观察开腹手术和腹腔镜不同气腹环境对大鼠系统免疫功能的影响。方法　将 6 0只雌性S-D大鼠随机分为 4组 :开腹组 ;CO2 气腹组 ;无气组 ;N2 气腹组 ,每组 15只。模拟开腹手术和相应腹腔镜手术时的气腹环境 ,时间为 1h。分别于手术第 0、1、3、7d检测大鼠血液中CD3 、CD4和CDRT细胞的数值变化 ,了解开腹及不同气腹对大鼠系统免疫功能的影响。结果　术后各组CD细胞计数值均明显下降 (P <0 .0 0 1) ,开腹组最低 (P <0 .0 0 1) ;CO2 气腹组居中 (P <0 .0 0 1) ,无气和N2 组间无统计学差异 (P >0 .0 5 ) ,免疫抑制程度最低。开腹组术后恢复最慢 (P <0 .0 1) ;CO2 气腹组居中 (P <0 .0 1) ,无气和N2 气腹组数值基本相同 (P >0 .0 5 ) ,恢复最快。第 7d各组印细胞计数均恢复术前正常水平 (P >0 .0 5 )。结论　CO2 气腹对系统免疫功能抑制程度小于开腹组 ,但大于无气或N2 气腹组 ,术后恢复晚于后两组。

EFFECT OF VARIOUS LAPAROSCOPIC PNENMOPERITONEUM ON SYSTEMIC IMMUNE FUNCTION IN A RAT MODEL

Objective:To observe the effect of laparotomy and various laparoscopic pneumoperitoneum on systemic immune function in a rat model.Methods:Sixty female S-D rats were divided randomly into four groups:laparotomy; carbon dioxide pneumoperitoneum;gasless and nitrogen gas pneumoperitoneum, fifteen rats of each group, simulating the laparotomy and various laparoscopic pneumoperitoneum procedure for lh. Pre and postoperative blood CD 3, CD 4 and CD 8 T cells were counted on day 0, 1, 3 and 7 respectively to discover the postoperative changes of systemic immune function. Results:Changes of systemic immune function: The postoperative CD 3, CD 4 and CD 8 counting results of the four groups decreased obviously on day 1 ( P <0.001), especially the lowest in group 1 ( P <0.001 ). The CD counting of CO 2 group were lower than laparotomy but higher than those of gasless and N 2 groups ( P <0. 001), there were no statistic differences between the latter two groups( P >0.05 ). All counting level of the four groups rised on day 3 with nearly the same fastest rise in group 3 and 4 ( P <0.01), the slowest rise in group 1( P <0.01) and a middle rise of group 2 in between ( P <0.01). The CD counting values recovered to normal in all groups on day 7 ( P >0.05).Conclusions:The suppression of systemic innnune function caused by CO 2 pneumoperitoneumon taparoscopy was less than that by laparotomy, but a little more than those caused by gasless or N 2 pneumoperitoneumon laparoscopy and recovered later than those of the two operation methods.