Ipek T, Paksoy M, Colak T, Polat E, Uygun N
Department of Surgery, Cerrahpasa Medical Faculty of Istanbul University, Istanbul, Turkey.
Surg Endosc. 1998 May;12(5):432-5. doi: 10.1007/s004649900697.
Laparoscopy is increasingly used in conditions complicated by peritonitis. A theoretical concern is that carbon dioxide pneumoperitoneum may increase bacteremia.
In 60 rats peritonitis was induced by cecostomy. Animals were randomly allocated to pneumoperitoneum (PP) and control groups. Blood cultures and intraabdominal swabs were assessed. A peritonitis severity score (PSS) was computed based on histology from peritoneal biopsy.
One hour after cecostomy neither in abdominal swabs nor in blood samples bacteria were reproduced in PP and control groups. Three hours after cecostomy the frequency of positive blood cultures was 80% and 20% in PP and control groups, respectively (p < 0.0001). Six hours after cecostomy the frequency of positive blood cultures was 100% in each group (p > 0.05). One hour after cecostomy the mean peritoneal severity score was significantly higher in the PP group than in the control group, but there was not any significant difference between groups 3 and 6 h after cecostomy. The mean peritoneal severity scores were found to be significantly increased with time when the PP groups compared with each other.
In rats, pneumoperitoneum can't cause a more severe peritonitis but it does induce an increase in the rate of bacteremia within the early 6-h period of peritonitis.
腹腔镜检查越来越多地用于并发腹膜炎的情况。一个理论上的担忧是二氧化碳气腹可能会增加菌血症。
在60只大鼠中，通过盲肠造口术诱发腹膜炎。将动物随机分为气腹组（PP）和对照组。评估血培养和腹腔拭子。根据腹膜活检的组织学计算腹膜炎严重程度评分（PSS）。
盲肠造口术后1小时，PP组和对照组的腹腔拭子和血样中均未培养出细菌。盲肠造口术后3小时，PP组和对照组血培养阳性率分别为80%和20%（p<0.0001）。盲肠造口术后6小时，每组血培养阳性率均为100%（p>0.05）。盲肠造口术后1小时，PP组的平均腹膜严重程度评分显著高于对照组，但盲肠造口术后3小时和6小时两组之间无显著差异。当PP组相互比较时，发现平均腹膜严重程度评分随时间显著增加。
在大鼠中，气腹不会导致更严重的腹膜炎，但会在腹膜炎的早期6小时内导致菌血症发生率增加。
