| 李享,高东艳,李凤姣,等.二氧化碳气腹对子宫肌瘤合并原发性高血压肠黏膜屏障的影响[J].安徽医药,2022,26(11):2257-2260. |
| 二氧化碳气腹对子宫肌瘤合并原发性高血压肠黏膜屏障的影响 |
| Effect of CO2 pneumoperitoneum on intestinal mucosal barrier in patients with uterine leiomyoma complicated with essential hypertension |
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| DOI：10.3969/j.issn.1009-6469.2022.11.031 |
| 中文关键词: 腹腔镜检查 妇科外科手术 肠黏膜 高血压 二氧化碳气腹 肠屏障损伤 紧密连接蛋白 -1 肿瘤坏死因子 -α |
| 英文关键词: Laparoscopy Gynecologic surgical procedures Intestinal mucosa Hypertension CO2 pneumoperitoneum In. testinal barrier injury Claudin-1 TNF-α |
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| 中文摘要: |
| 目的探讨腹腔镜手术二氧化碳气腹对子宫肌瘤合并原发性高血压( EH)病人肠黏膜屏障的影响。方法选取 2019年 6―12月山西医科大学第二医院拟在全麻下行腹腔镜子宫肌瘤剔除术的多发性子宫肌瘤合并 EH病人 20例纳入 EH组，同期相同病例的非高血压病人 20例纳入对照组；两组均常规行静脉麻醉诱导和维持，分别于麻醉诱导前 10 min(T1)气腹解除后 1h(T2)，气腹解除后 24 h(T3)取桡静脉血 5 mL，测定两组病人血清紧密连接蛋白 -1(Claudin-1)蛋白和肿瘤坏死因子-，α(TNF-α)的含量并记录两组病人术后排气功能恢复时间。结果与 T1比较， T2、T3时刻两组病人 TNF-α含量均增高( P<0.01)Claudin-1含量均减低( P<0.01)；与对照组比较，(11.57±1.20)ng/L比( 10.24±1.09)ng/L，(13.3，0±1.57) ng/L比( 11.77±1.43)ng/L，T3在相同时间 EH组 TNF-α含量［ T1T2(12.55±1.93)ng/L比( 11.15±1.15)ng/L］和术后排气功能恢复时间［( 20.35±3.20)h比( 16.85±2.60)h］高于对照组， Claudin-1含量低于对照组［ T1T2(99.60±11.84)ng/L比( 110.40±8.42)ng/L，(83.16±14.56)ng/L比( 95.56±10.26)ng/L， T(386.10±12.70)ng/L比( 99.35±10.72)ng/L］(P<0.01)。结论妇科腹腔镜手术二氧化碳气腹会通过增加炎性因子的释放加强炎症反应，并抑制肠黏膜屏障 Claudin-1蛋白的表达使病人肠黏膜屏障功能损伤；而当病人合并 EH时，气腹引起的肠黏膜屏障损伤加重。 |
| 英文摘要: |
| Objective To investigate the effect of CO2pneumoperitoneum on intestinal mucosal barrier in patients with uterine leio.myoma complicated with essential hypertension (EH) by laparoscopy.Methods Twenty patients with multiple uterine leiomyoma com.plicated by laparoscopic myomectomy EH general anesthesia in the Second Hospital of Shanxi Medical University from June to Decem.ber 2019 were included in EH group. At the same time, 20 non-hypertensives were included in the control group. Both groups were rou.tinely induced and maintained by intravenous anesthesia, 10 min before anesthesia induction (T1), 1 h after pneumoperitoneum release (T2), and 24 h after pneumoperitoneum release (T3), radial venous blood was taken for 5 mL. The contents of serum Claudin-1 protein and TNF-α in both groups were determined and the recovery time of exhaust function was recorded.Results Compared with the T1,the TNF-α content of the two groups increased (P<0.01) and the Claudin-1 content decreased (P<0.01). Compared with the control group, the TNF-α content [T1 (11.57±1.20) ng/L vs. (10.24±1.09) ng/L,T2 (13.30±1.57) ng/L vs. (11.77±1.43) ng/L,T3 (12.55±1.93) ng/L vs. (11.15±1.15) ng/L] and postoperative exhaust function recovery time [(20.35±3.20) h vs. (16.85±2.60) h] were higher than those of the control group (P<0.01). Compared with the control group, the Claudin-1 content was lower than that of the control group [T1 (99.60± 11.84) ng/L vs. (110.40±8.42) ng/L, T2 (83.16±14.56) ng/L vs. (95.56±10.26) ng/L, T3 (86.10±12.70) ng/L vs. (99.35±10.72) ng/L] (P< 0.01).Conclusion Gynecological laparoscopic surgery CO2 pneumoperitoneum can strengthen inflammatory response by increasingthe release of inflammatory factors and inhibit the expression of intestinal mucosal barrier Claudin-1 protein, which can damage thefunction of intestinal mucosal barrier in patients, while patients are combined with EH, the intestinal mucosal barrier injury caused bypneumoperitoneum is aggravated. |
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