Wang Gang, Wu Rongde, Guo Feng, Liu Wei, Chen Xinguo, Yu Qihai
Department of Pediatric Surgery, Provincial Hospital affiliated with Shandong University , Jinan, Shandong, China .
J Laparoendosc Adv Surg Tech A. 2014 Mar;24(3):199-204. doi: 10.1089/lap.2013.0129. Epub 2014 Feb 25.
This study evaluated the effect of CO2 pneumoperitoneum on intraabdominal infection and bacterial translocation in intraabdominal infection.
Escherichia coli and Bacteroides fragilis were injected separately into the abdominal cavities of 30 New Zealand white rabbits to establish two animal models of intraabdominal infection. Each model was divided into a laparotomy group, a pneumoperitoneum group, and a control group. Before and 1, 2, 4, and 7 days after surgery, blood and peritoneal fluids were obtained to determine bacterial culture and serum interleukin-6, tumor necrosis factor-α, and C-reactive protein levels by enzyme-linked immunosorbent assay. The total number of white blood cells (WBCs) was measured. Seven days after surgery, the animals were sacrificed and dissected, and liver, kidney, and spleen tissues were obtained for bacterial culture.
In the two bacterial models, incidence rates of bacteremia were higher in the laparotomy and pneumoperitoneum groups than in the control group. However, there were no significant differences between the laparotomy and pneumoperitoneum groups. Visceral bacterial translocation was detected in each group with no significant difference among the three groups. The change of inflammatory factors in the E. coli group and the B. fragilis group was nearly the same: the inflammatory factor levels and WBC counts in the laparotomy group were significantly higher than in the pneumoperitoneum group. The inflammatory factor levels and WBC counts in the pneumoperitoneum group increased slowly and were restored to normal quickly.
In the intraabdominal infection animal model of the pneumoperitoneum group, the inflammatory response was weaker and the immune function was less affected and restored to normal more quickly than in the laparotomy group. The incidence rate of visceral bacterial translocation was not higher than that in the laparotomy group.
本研究评估了二氧化碳气腹对腹腔内感染及腹腔内感染时细菌移位的影响。
将大肠杆菌和脆弱拟杆菌分别注入30只新西兰白兔腹腔，建立两种腹腔内感染动物模型。每种模型分为剖腹手术组、气腹组和对照组。在手术前及术后1、2、4和7天，采集血液和腹腔液，通过酶联免疫吸附测定法测定细菌培养及血清白细胞介素-6、肿瘤坏死因子-α和C反应蛋白水平。测量白细胞总数。术后7天，处死动物并解剖，获取肝、肾和脾组织进行细菌培养。
在两种细菌模型中，剖腹手术组和气腹组的菌血症发生率均高于对照组。然而，剖腹手术组和气腹组之间无显著差异。每组均检测到内脏细菌移位，三组之间无显著差异。大肠杆菌组和脆弱拟杆菌组炎症因子的变化情况基本相同：剖腹手术组的炎症因子水平和白细胞计数显著高于气腹组。气腹组的炎症因子水平和白细胞计数上升缓慢且较快恢复正常。
在气腹组的腹腔内感染动物模型中，与剖腹手术组相比，炎症反应较弱，免疫功能受影响较小且恢复正常更快。内脏细菌移位发生率不高于剖腹手术组。
