Şinikoğlu Nadir Sıtkı, Gümüş Funda, Şanlı Nalan, Totoz Tolga, Alagöl Ayşin, Turan Nesrin
Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
Department of Biostatistics, Trakya University Faculty of Medicine, Edirne, Turkey.
Turk J Anaesthesiol Reanim. 2015 Apr;43(2):73-7. doi: 10.5152/TJAR.2014.83604. Epub 2015 Feb 5.
In our study, we aimed to investigate the effect of laparoscopic procedures in which the abdominal cavity at a Trendelenburg position of 15 degrees was insufflated with CO2 on cardiac and liver markers.
Forty patients scheduled for laparoscopic gynaecological surgery were included in the study. Venous blood samples were taken the day before operation and 6 hours after surgery, and later, lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase-MB (CK-MB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), myoglobin (MY) and d-dimer (d-D) were measured.
There was no statistically significant difference in the values of preoperative and postoperative ALT (16.8±9.4 and 17.8±9.3; p=0.579), AST (19.4±7 and 20.9±7.6; p=0.361) and ALP (65.2±16.2 and 63.3±16.9; p=0.609), but LDH (385.1±117.3 and 460.6±156.3; p=0.003), CK (113.8±138.5 and 247.9±283.5; p=0.0001), CK-MB (22.8±13.3 and 28.7±16; p=0.011), MY (28.1±12.9 and 138.8±129; p=0.0001) and d-D (509.5±815: 1026±1054; p=0.0001) increased significantly.
After laparoscopic operations in the Trendelenburg position, postoperative serum ALT, AST and ALP levels, remained unchanged, when compared to preoperative values, but LDH, CK, CK-MB, myoglobin and d-dimer values increased significantly.
在我们的研究中，我们旨在调查在头低脚高位15度的腹腔内注入二氧化碳的腹腔镜手术对心脏和肝脏标志物的影响。
本研究纳入了40例计划进行腹腔镜妇科手术的患者。在手术前一天和手术后6小时采集静脉血样本，随后测量乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、碱性磷酸酶（ALP）、肌红蛋白（MY）和D-二聚体（d-D）。
术前和术后ALT（16.8±9.4和17.8±9.3；p=0.579）、AST（19.4±7和20.9±7.6；p=0.361）和ALP（65.2±16.2和63.3±16.9；p=0.609）的值无统计学显著差异，但LDH（385.1±117.3和460.6±156.3；p=0.003）、CK（113.8±138.5和247.9±283.5；p=0.0001）、CK-MB（22.8±13.3和28.7±16；p=0.011）、MY（28.1±12.9和138.8±129；p=0.0001）和d-D（509.5±815：1026±1054；p=0.0001）显著升高。
在头低脚高位进行腹腔镜手术后，与术前值相比，术后血清ALT、AST和ALP水平保持不变，但LDH、CK、CK-MB、肌红蛋白和D-二聚体值显著升高。
