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首页> 外文期刊>Surgical Endoscopy >Intestinal histopathological changes in a porcine model of pneumoperitoneum-induced intra-abdominal hypertension
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Intestinal histopathological changes in a porcine model of pneumoperitoneum-induced intra-abdominal hypertension

机译：胃肠内诱导的腹腔内高血压肠道模型中的肠组织病理学变化

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Background Low splanchnic perfusion is an immediate effect of pneumoperitoneum-induced intra-abdominal hypertension (IAH). Anatomical structure results in the intestinal mucosa being the area most sensitive to hypoperfusion. The relationship between intestinal injury and clinical parameters of tissue perfusion [abdominal perfusion pressure (APP), gastric intramucosal pH (pH~(i)) and lactic acid (Lc)] has not been previously studied. This study aimed to monitorize intestinal pathogenesis through sequential ileal biopsies and to measure APP, pH~(i), and Lc levels at different pneumoperitoneum-induced intra-abdominal pressures (20, 30, and 40?mmHg) to evaluate the potential relationships between them. Materials and methods Fifty pigs were divided into four groups; a control group (C) and three experimental groups with different pneumoperitoneum-induced levels [20?mmHg (G20), 30?mmHg (G30), and 40?mmHg (G40)], that were maintained for 3 and 5?h. APP, pH~(i), and Lc were measured and ileal biopsies taken laparoscopically every 30?min. The mucosal damage was graded using the standardized Park’s Score and animals were classified as injured ( I +) or uninjured ( I ?). Results Different histopathological lesions were observed in groups G20, G30, and G40 but no damage observed in group C. A 33.3% of animals in G20 and G30 were I + after 3?h, while 93.3% were injured in G40. After 5?h, histopathological lesions were no longer seen in some animals in G20 and only 10% were I +. Conversely, in G30 I + pigs increased to 80% while those in G40 remained at 93.3% I +. The I + animals had significantly lower APP and pH~(i)than those I ?. Lc was the clinical parameter that showed the earliest differences, with significantly higher figures in I + animals. Conclusions The evolution of intestinal injuries from pneumoperitoneum-induced IAH depends on the degree of IAP. These damages may be associated with decreases in APP and pH~(i), and increases in Lc.
机译：背景技术低炼素灌注是肺腹腔内腹腔内高血压（IAH）的即时作用。解剖结构导致肠粘膜是对低血量灌注最敏感的区域。尚未研究肠毛伤与组织灌注临床参数的关系[腹灌注压力（APP），胃腔内pH（pH〜（I））和乳酸（LC）]。本研究旨在通过顺序肝脏活组织检查监测肠道发病机制，并测量不同肺胆管内诱导的腹内压力（20,30和40μmHG）的应用，pH〜（i）和LC水平，以评估潜在的关系他们。材料和方法50只猪分为四组;一种对照组（C）和具有不同肺型物质诱导的水平的三个实验组[20？mmHg（G20），30？mmHg（G30）和40μlmmHg（G40）]，其保持为3和5μl。 APP，pH〜（i）和LC测量，每30？min腹腔镜拍摄的eLEAL活组织检查。使用标准化的公园的分数分级粘膜损伤，动物被归类为受伤（I +）或未受伤（I？）。结果在基团G20，G30和G40中观察到不同的组织病理病变，但在C组中没有观察到的损伤。33.3％的33.3％的动物在3℃，而93.3％在G40中受伤。 5？H后，在G20中的一些动物中不再看到组织病理病变，只有10％是I +。相反，在G30中，I +猪增加到80％，而G40的猪仍保持在93.3％I +。 i +动物的应用程序显着降低了应用程序和pH〜（i）而不是那些我？。 LC是表现出最早差异的临床参数，I +动物中具有明显更高的图。结论肠腹诱导的IAH肠损伤的演变取决于IAP的程度。这些损害可能与APP和PH〜（i）的降低相关，并增加LC。

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