摘要
目的观察妇科CO2气腹腹腔镜手术前、中、后不同时间点血浆中肾上腺髓质素（ADM）和降钙素基因相关肽（CGRP）的动态变化规律。方法选择我院行妇科腹腔镜手术患者47例，用放射免疫方法（RIA）测定麻醉前（T0）、气腹前10min（T1）、气腹形成后10min（T2）、30min（T3）、60min（T4）及解除气腹后30min（T5）血浆中ADM和CGRP含量。结果CO2气腹形成前后不同时间点ADM和CGRP水平差异经统计学分析均有统计学意义（，值分别为9．686、49．804，P均〈0．01）。血浆ADM和CGRP含量在麻醉前（T0）与气腹前10min（T1）差异无统计学意义（P均〉0．05）；CO2气腹形成后10min（T2）ADM开始下降（P〈0．05），CGRP下降较慢，与气腹前相比无显著变化（P〉0．05），随着气腹时间延长，30min（T3）和60min（T4）时血浆中ADM和CGRP水平显著低于气腹前（T1）（P均〈0．01）；解除气腹后30min（T5），两者均恢复到T1水平。结论妇科腹腔镜手术时CO2气腹是引起ADM和CGRP的降低的主要因素；ADM和CGRP降低对心脏内分泌功能的影响明显，心脏疾病和内分泌异常患者行CO2气腹手术要慎重。
Objective To observe the dynamic changes of adrenomedulin（ADM） and calcitonin-gene-related peptide （CGRP） at different time before, during and after ｜aparoseopic operation for treating CO2 pneumoperitoneum. Methods 47 cases undergoing laparoseopic operation in our hospital were selected. Plasma ADM and CGRP levels were determined by RIA before anesthesia（T0） ,10 min before （T1） and 10 min （T2） ,30 min （T3） ,60 min （T4）, and 30 min （T5） after CO2 pneumoperitoneum was treated. Results There was statistical significance in ADM and CGRP level at the different time points before and after CO2 pneumoperitoneum（ F = 9. 686 and 49. 804, P 〈 0.01 ）. There was no significance in ADM and CGRP level at TO and T1 （P 〉 0.05 ） ;ADM level would decrease at T2 （ P 〈 0.05 ） but CGRP level decrease slowly with no remarkable change as compared with that before CO2 pneumoperitoneum （P 〉 0.05 ）. With time going on, ADM and CGRP level at T3 and T4 was remarkably lower than that at T1 （ P 〈0.01 ） ;ADM and CGRP level at T5 would come to that at T1. Conclusions CO2 pneumoperitoneum during laparoscopic operation is the major factor causing decreased ADM and CGRP level;The decrease of ADM and CGRP level will influence the cardiac endocrine function, so CO2 pneumoperitoneum operation should be taken seriously when the patients have heart disease and cryptorrhea.
出处
《中国综合临床》
2009年第11期1207-1208,共2页
Clinical Medicine of China
关键词
腹腔镜手术
气腹
肾上腺髓质素
降钙素基因相关肽
Aparoscopie operation
Pneumoperitoneum
Adrenomedulin
Calcitonin-gene-related peptide
