Evasovich M R, Clark T C, Horattas M C, Holda S, Treen L
Department of General Surgery, Akron General Medical Center, 400 Wabash Avenue, Akron, OH 44307, USA.
Surg Endosc. 1996 Dec;10(12):1176-9. doi: 10.1007/s004649900273.
To evaluate the impact of laparoscopy in the presence of peritonitis, this study was designed to assess bacteremia caused by E. coli-induced peritonitis with a carbon dioxide pneumoperitoneum in a rat model.
Sixty Sprague-Dawley rats were divided into inoculum groups (no E. coli, 10(6) colony-forming units [CFU] E. coli, and 10(8) CFU E. coli), followed by induction of a carbon dioxide pneumoperitoneum or no pneumoperitoneum. Fifteen-minute-interval blood cultures were obtained to determine time of bacteremia development. Statistical assessment to determine significant differences among groups was done using ANOVA and t-test analysis.
A total of 20 animals with E. coli introduced into the peritoneum and a carbon-dioxide-induced pneumoperitoneum had more frequent positive blood cultures at all time intervals compared to identical inoculum subgroups without a pneumoperitoneum. ANOVA revealed a significant difference in bacteremia within the same concentration inoculum groups in animals receiving a pneumoperitoneum vs none (p < 0.01). Bacteremia increased significantly as inoculum concentrations increased (25% with 10(6) E. coli inoculum vs 80% with 10(8) E. coli), especially among the insufflated subgroups (45% with 10(6) E. coli vs 100% with 10(8) E. coli) over 180 min (p < 0.01).
Carbon dioxide pneumoperitoneum increases the incidence of E. coli bacterial translocation from the peritoneum into the bloodstream in this rat model.
为评估腹腔镜检查在腹膜炎情况下的影响，本研究旨在通过大鼠模型评估二氧化碳气腹对大肠杆菌诱导的腹膜炎所致菌血症的影响。
将60只Sprague-Dawley大鼠分为接种组（无大肠杆菌、10⁶ 菌落形成单位[CFU]大肠杆菌和10⁸ CFU大肠杆菌），随后进行二氧化碳气腹或不进行气腹。每隔15分钟采集血培养样本以确定菌血症发生时间。使用方差分析和t检验分析进行统计学评估，以确定各组间的显著差异。
与未进行气腹的相同接种亚组相比，总共20只腹腔内注入大肠杆菌并进行二氧化碳诱导气腹的动物在所有时间间隔的血培养阳性率更高。方差分析显示，接受气腹与未接受气腹的动物在相同浓度接种组中的菌血症存在显著差异（p < 0.01）。随着接种浓度的增加，菌血症显著增加（10⁶ 大肠杆菌接种组为25%，而10⁸ 大肠杆菌接种组为80%），特别是在气腹亚组中（10⁶ 大肠杆菌接种组为45%，而10⁸ 大肠杆菌接种组在180分钟内为100%）（p < 0.01）。
在该大鼠模型中，二氧化碳气腹增加了大肠杆菌从腹膜向血流的细菌移位发生率。
