二氧化碳气腹时血浆促肾上腺皮质激素及皮质醇浓度的变化

目的：检测妇科腹腔镜手术中血浆促肾上腺皮质激素（ACTH）及皮质醇（Col）浓度的变化，评价其临床价值。方法：采用放射免疫法测定47例患者气腹前10min、气腹建立后10min、30min、60min及解除气腹后10min血浆中ACTH及Col的含量。结果：气腹前与气腹解除后血浆中ACTH、Col含量无明显差异（P〉0．05）。气腹建立后10min及30min两种激素含量均比气腹前升高（P〈0．05）。气腹建立后60min，Col含量仍比气腹前明显升高（P〈0．05），ACTH含量无差异性改变（P〉0．05）。结论：妇科腹腔镜手术中，C02气腹对血浆ACTH及Col浓度具有明显的影响。

Changes in plasma ACTH and cortisol concentrations after CO2 pneumoperitoneum

Objective:To observe the changes in plasma adrenocorticotropic hormone(ACTH) and cortisol(Col) concentrations after CO_2 pneumoperitoneum in patients undergoing gynecological laparoscopy.Methods: A total of 47 gynecological patients were studied during CO_2 insufflation.Venous blood samples were obtained for detecting plasma concentrations of ACTH and Col by radioimmunoassay at the following five time points: 10 min before(insufflation,)at 10 min,30 min and 60 min after insufflation respectively and 10 min after desufflation.Results: The plasma concentrations of ACTH and Col had no significant difference between before insufflation and after(desufflation)(P>0.05).Both ACTH and Col concentrations at 10 min and 30 min after insufflation were higher than those before insufflation(P<0.05).The concentration of Col at 60 min after insufflation was higher than that before insufflation(P<0.05),and the ACTH concentration at 60 min after insufflation had no significant change compared with before pneumoperitoneum(P>0.05).Conclusions: Plasma ACTH and Col concentrations were markedly increased after CO_2 pneumoperitoneum in gynecological patients undergoing(laparoscopic) surgery.