Lindberg F, Bergqvist D, Björck M, Rasmussen I
Department of Surgery, Skellefteå Hospital, 931 86 Skellefteå, Sweden.
Surg Endosc. 2003 Mar;17(3):480-4. doi: 10.1007/s00464-002-9044-y. Epub 2002 Nov 6.
Laparoscopic living donor nephrectomy is increasingly being performed, although the effects of carbon dioxide pneumoperitoneum (CO2 PP) on renal function and hemodynamics and the levels of vasopressin are not well studied.
Renal blood flow, renal venous pressure, urine output, and vasopressin concentrations in renal venous blood were measured in pigs subjected to 12 mmHg of CO2 PP for 150 min.
Renal blood flow was decreased at induction of PP and increased during the first 30 min after exsufflation. Renal venous pressure was increased during PP. There was indirect evidence of a decrease in urine output during PP. No changes in renal venous vasopressin concentrations were seen.
A CO2 PP of 12 mmHg causes changes in renal hemodynamics and urine output. No changes in vasopressin levels were seen in this pig model, suggesting that other explanations for the observed changes must be sought.
尽管二氧化碳气腹(CO2 PP)对肾功能、血流动力学及血管加压素水平的影响尚未得到充分研究,但腹腔镜活体供肾切除术的开展越来越多。
对猪施加12 mmHg的CO2 PP持续150分钟,测量其肾血流量、肾静脉压力、尿量及肾静脉血中血管加压素浓度。
气腹诱导时肾血流量减少,排气后最初30分钟内增加。气腹期间肾静脉压力升高。有间接证据表明气腹期间尿量减少。肾静脉血管加压素浓度未见变化。
12 mmHg的CO2 PP可导致肾血流动力学及尿量改变。在此猪模型中未观察到血管加压素水平变化,提示必须寻找对所观察到变化的其他解释。