Tsuboi S, Kitano S, Yoshida T, Bandoh T, Ninomiya K, Baatar D
First Department of Surgery, Oita Medical University, Oita 879-5593, Japan.
Surg Endosc. 2002 Aug;16(8):1220-5. doi: 10.1007/s00464-001-9163-x. Epub 2002 May 3.
The aim of our study was to investigate the effect of carbon dioxide pneumoperitoneum on systemic and splanchnic hemodynamics in cirrhotic rats.
Sprague-Dawley rats (n = 80) were used in this study. Liver cirrhosis was induced by thioacetamide administration intraperitoneally (200 mg/kg body weight, twice a week for 16 weeks). The radioactive microsphere method was used to measure systemic and regional hemodynamic parameters before, 1 h after the start, and 1 h after the release of pneumoperitoneum.
Splanchnic blood flow and cardiac index were significantly depressed during pneumoperitoneum in liver cirrhosis and control groups, but no significant differences were seen between the two groups. In both groups, portal venous inflow decreased and hepatic arterial blood flow increased significantly during pneumoperitoneum. However, during pneumoperitoneum, total hepatic blood flow as a percentage of its value before pneumoperitoneum was lower in cirrhotic rats (71.0%) than in control rats (91.9%) (p <0.05, Mann-Whitney U-test).
Carbon dioxide pneumoperitoneum markedly decreases total hepatic blood flow in cirrhotic rats due to the impaired hepatic arterial buffer response. Liver function should be carefully controlled in cirrhotic patients after laparoscopic surgery with pneumoperitoneum.
本研究旨在探讨二氧化碳气腹对肝硬化大鼠全身及内脏血流动力学的影响。
本研究使用了80只Sprague-Dawley大鼠。通过腹腔注射硫代乙酰胺（200mg/kg体重，每周两次，共16周）诱导肝硬化。采用放射性微球法在气腹开始前、开始后1小时及气腹解除后1小时测量全身及局部血流动力学参数。
肝硬化组和对照组在气腹期间内脏血流量和心脏指数均显著降低，但两组之间无显著差异。在两组中，气腹期间门静脉血流量减少，肝动脉血流量显著增加。然而，气腹期间，肝硬化大鼠的肝总血流量占气腹前值的百分比（71.0%）低于对照组大鼠（91.9%）（p<0.05，Mann-Whitney U检验）。
由于肝动脉缓冲反应受损，二氧化碳气腹显著降低肝硬化大鼠的肝总血流量。肝硬化患者在腹腔镜气腹手术后应仔细监测肝功能。
