在腹膜炎模型中，腹腔镜检查会增加菌血症和内毒素血症吗？

Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model?

作者信息

Jacobi C A, Ordemann J, Böhm B, Zieren H U, Volk H D, Lorenz W, Halle E, Müller J M

机构信息

Department of Surgery, University of Berlin, Charité, Germany.

出版信息

Surg Endosc. 1997 Mar;11(3):235-8. doi: 10.1007/s004649900333.

DOI:10.1007/s004649900333

PMID:9079599

Abstract

BACKGROUND

Laparoscopy is increasingly used in patients with intraabdominal bacterial infection although pneumoperitoneum may increase bacteremia by elevated intraabdominal pressure.

METHODS

The influence of laparotomy and laparoscopy on bacteremia, endotoxemia, and postoperative abscess formation was investigated in a rat model. Rats received intraperitoneally a standardized fecal inoculum and underwent laparotomy (n = 20), or laparoscopy (n = 20), or no further manipulation in the control group (n = 20).

RESULTS

Bacteremia and endotoxemia were higher after laparotomy and laparoscopy compared to the control group (p = 0.01) 1 h after intervention. One hour after intervention, aerobic and anaerobic bacterial species were detected in the laparotomy group while only anaerobic bacteria were found in the other two groups. Although bacteremia and endotoxemia did not differ among the three groups after 1 week, the mean number of intraperitoneal abscesses was significantly higher (p < 0.05) after laparotomy (n = 10) compared with laparoscopy (n = 6) and control group (n = 5).

CONCLUSION

Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model of peritonitis.

摘要

背景

尽管气腹可能因腹内压升高而增加菌血症，但腹腔镜检查在腹腔内细菌感染患者中的应用越来越广泛。

方法

在大鼠模型中研究剖腹术和腹腔镜检查对菌血症、内毒素血症及术后脓肿形成的影响。大鼠腹腔内接种标准化粪便接种物，然后进行剖腹术（n = 20）、腹腔镜检查（n = 20），对照组不进行进一步操作（n = 20）。

结果

与对照组相比，干预后1小时剖腹术和腹腔镜检查后的菌血症和内毒素血症更高（p = 0.01）。干预后1小时，剖腹术组检测到需氧菌和厌氧菌，而其他两组仅发现厌氧菌。尽管1周后三组之间的菌血症和内毒素血症无差异，但与腹腔镜检查组（n = 6）和对照组（n = 5）相比，剖腹术后腹腔脓肿的平均数量显著更高（p < 0.05）（n = 10）。