Dissertation
Dissertation > Medicine, health > Surgery > Of surgery > Abdominal surgery > Pancreas > Pancreatitis

Effect of Carbon Dioxide Pneumoperitoneum on the Sever Acute Pancreatitis on Lung Tissue、lung NF-KB and ET/NO in Serum

Author LiuBingGang
Tutor QinChunHong
School Nanhua University
Course Department of General Surgery
Keywords Severe Acute Pancreatitis CO2 pneumoperitoneum NO ET NF-KB
CLC R657.51
Type Master's thesis
Year 2010
Downloads 31
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Objective: To investigate the CO 2 pneumoperitoneum on severe acute pancreatitis rabbit lung tissue, lung NF-KB and blood ET / NO may affect laparoscopy in the treatment of SAP applications to provide experimental basis. Methods: 30 New Zealand white rabbits, male and female and female, were randomly divided into three groups: (1) CO 2 pneumoperitoneum group 10, 5% sodium taurocholate into the pancreatic duct the retrograde injection method prepared severe acute pancreatitis rabbit animal model, the SAP modeling successful six hours after New Zealand rabbits were intra-abdominal laparoscopic pneumoperitoneum injected CO 2 gas pressure of 12mmHg for 120 minutes; (2) open group and the 10 build SAP model after the abdomen was closed, not CO 2 gas filled; (3) the control group, 10, only to open flip pancreas abdomen was closed. Pneumoperitoneum group experimental animals were sacrificed immediately at the end of the inflatable laparotomy group and the control group were sacrificed 8 hours after the modeling and experimental animals, and laparotomy in the inferior vena cava blood, the radioimmunoassay detection ET, nitrate reductase assay NO automatic biochemical analyzer detects serum amylase; laparotomy under the abdominal aorta blood, blood gas analyzer Arterial blood PO 2 and PCO 2 ; of detecting lung tissue NF -KB expression index for lung wet-to-dry ratio determination; checks cut pancreatic and lung tissue for pathological ordinary light microscope. analysis of three sets of experimental data. Results: () CO 2 pneumoperitoneum group and laparotomy group, pathological changes of the pancreas ordinary light microscope shows multifocal pancreatic necrosis, inflammatory cell infiltration and hemorrhage, pathology score high; normal pancreas structure of the control group, the cells did not significantly degeneration, necrosis and inflammatory cell infiltration, perivascular inflammatory reaction. The the CO 2 pneumoperitoneum group pancreatic pathological score (10.1 ± 1.64) and laparotomy group pancreatic pathology score (9.3 ± 1.31) and control group (1.0 ± 0.05) difference between statistical significance (P lt; 0.05); CO 2 the pneumoperitoneum group with laparotomy group the pathological score difference was not statistically significant (P = 0.294). CO 2 pneumoperitoneum and laparotomy group by ordinary light microscopy of lung pathological changes in lung tissue alveolar wall generally thickening seen in neutrophil infiltration, capillary mild expansion, congestion, alveolar space visible edema fluid exudation and inflammatory cell infiltration, exudate in the bronchial lumen bronchial epithelial cell degeneration and necrosis, inflammatory cell infiltration of the wall and surrounding tissue; morphologically normal lung tissue of the control group, the bronchial lumen exudate, bronchial epithelial No degeneration necrosis, wall and surrounding organization no infiltration of inflammatory cells, no significant thickening of the alveolar septa, alveolar cavity without oozing, endobronchial exudate. CO 2 the pneumoperitoneum group of lung pathology score (4.67 ± 1.22) and the open lung tissue pathology score (4.30 ± 1.25) and the control group (1.70 ± 0.82) difference was statistically significant (P lt; 0.05). CO 2 the pneumoperitoneum group with laparotomy group between pathology score difference was not statistically significant (P = 0.85) (2) lung wet / dry weight ratio: CO 2 pneumoperitoneum group (5.03 ± 1.47), laparotomy group (4.69 ± 1.73) and the control group, (1.56 ± 0.85). CO 2 pneumoperitoneum group and laparotomy group and the control group, lung wet / dry weight ratio was significantly higher difference was statistically significant (P lt; 0.05); CO 2 pneumoperitoneum group with laparotomy group between lung wet / dry ratio difference was not statistically significant (P = 0.105). (3) serum amylase: CO 2 pneumoperitoneum group (2856 ± 730), laparotomy group (2619 ± 693) and the control group (422 ± 91), CO 2 the pneumoperitoneum group laparotomy group blood AMY with the control group was significantly higher difference was statistically significant (P lt; 0.05); CO 2 the pneumoperitoneum groups and between the laparotomy group blood AMY no difference statistically significant (P = 0.174). (4) endothelin (ET) / nitric oxide (NO): the CO 2 pneumoperitoneum group: 1.43 ± 0.08; laparotomy group: 1.39 ± 0.06; control group: 0.91 ± 0.03. Variance analysis on each group: the CO 2 pneumoperitoneum group and laparotomy group than in the control group was significantly higher, and the difference was statistically significant (P lt; 0.05). CO 2 the pneumoperitoneum group with laparotomy group did not change significantly, the difference was not statistically significant (P = 0.312). (5) lung tissue NF-KB expression index: CO 2 the Veress group (0.38 ± 0.12), laparotomy group (0.44 ± 0.14) and control group (0.19 ± 0.08), CO 2 the pneumoperitoneum and open lung tissue NF-KB expression index compared with control group was significantly higher difference was statistically significant (P lt; 0.05); the CO 2 pneumoperitoneum group and lung tissue NF-KB expression index difference between the laparotomy group was not statistically significant (P = 0.324). (6) blood PO 2 average of: CO 2 pneumoperitoneum group (74.5 ± 2.3). Laparotomy group (76.1 ± 1.7) and control group (98.0 ± 4.1) , CO 2 the the pneumoperitoneum groups and laparotomy groups blood PO 2 average control group than significantly reducing the difference was statistically significant (P lt; 0.05); CO 2 the pneumoperitoneum groups and between the laparotomy group blood PO 2 average of no significant change in the difference was not statistically significant (P = 0.205). (7) blood PCO 2 average of: CO 2 pneumoperitoneum group, laparotomy group, the control group, blood PCO 2 average were 54.30 ± 3.40,52.5 ± 2.0 and 40.2 ± 2.20, CO 2 the pneumoperitoneum group laparotomy group blood PCO 2 average control group increased more than obvious difference was statistically significance (P lt; 0.05); the CO 2 pneumoperitoneum group and laparotomy group blood PCO 2 average of no significant change in the difference was not statistically significant (P = 0.173 ). Conclusion: CO 2 pneumoperitoneum may rabbit lung tissue of severe acute pancreatitis, no significant effect on lung NF-KB expression and blood ET / NO.

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