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首页> 外文期刊>Surgical Endoscopy >Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.
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Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.

机译：腹腔镜检查中压力和气体类型对腹内，皮下和血液pH的影响。

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BACKGROUND: According to the literature, the number of port-site metastases in laparoscopic surgery varies considerably depending on the type of gas used for the pneumoperitoneum. In order to investigate this observation we studied the changes in blood, subcutaneous, and intra-abdominal pH during laparoscopy with helium, CO(2) and room air in a rat model. In addition, we looked at the influence of intra-abdominal pressure and duration of pneumoperitoneum on the pH during the laparoscopy. METHODS: pH was measured by tonometry, intra-abdominally and subcutaneously. A pH electrode was additionally placed into the subcutaneous tissue and the results compared to those measured by tonometry. Blood samples were taken from a catheter in the carotid artery. The intra-abdominal pressure was 0, 3, 6, 9 mm Hg for 30 min in each case. We investigated the effect of pneumoperitoneum with CO(2), helium and air in randomized groups of 5 rats. In an additional series the pressure was held constant at 3 mm Hg and the pH was measured every 30 min. RESULTS: Due to the different absorption capacity of the peritoneum, laparoscopy with CO(2) decreases the subcutaneous pH from 7.35 to 6.81. Blood pH is reduced from 7.37 to 7.17 and the intra-abdominal pH from 7.35 to 6.24. Other, less absorbable gases induce smaller changes of blood and subcutaneous pH (only 10% of CO(2)). In a variance analysis the p value is less than 0.001. The influence of duration of laparoscopy (30 min vs. 90 min) on the subcutaneous pH is less compared to the influence of intra-abdominal pressure (0, 3, 6, 9 mm Hg). CONCLUSIONS: Depending on the type of gas (CO(2), air, helium) used for laparoscopy blood, subcutaneous and intra-abdominal pH are influenced differently. Because lower pH is known to impair local defense mechanisms, these results may be one explanation for the higher incidence of port-site metastasis in laparoscopy with CO(2) than with other gases, as reported in the literature.
机译：背景：根据文献，腹腔镜手术中的端口转移灶的数量根据气腹所用气体的类型而有很大不同。为了调查此观察结果，我们研究了在大鼠模型中用氦气，CO（2）和室内空气进行腹腔镜检查期间血液，皮下和腹内pH的变化。此外，我们观察了腹腔镜检查期间腹腔内压力和气腹持续时间对pH值的影响。方法：通过眼压法，腹部内和皮下测量pH。将pH电极另外放置在皮下组织中，并将结果与​​通过眼压法测得的结果进行比较。从颈动脉中的导管中取血样。在每种情况下，腹腔内压力分别为0、3、6、9 mm Hg，持续30分钟。我们调查了CO（2），氦气和空气在5组大鼠的随机分组中对气腹的影响。在另一个系列中，压力保持恒定在3 mm Hg，每30分钟测量一次pH。结果：由于腹膜的吸收能力不同，腹腔镜用CO（2）将皮下pH值从7.35降低到6.81。血液pH值从7.37降低到7.17，腹内pH值从7.35降低到6.24。其他吸收性较小的气体会引起血液和皮下pH值的变化较小（仅占CO（2）的10％）。在方差分析中，p值小于0.001。与腹腔内压力（0、3、6、9 mm Hg）的影响相比，腹腔镜持续时间（30分钟对90分钟）对皮下pH的影响较小。结论：根据腹腔镜检查血液所用的气体（CO（2），空气，氦气）的类型，皮下和腹腔内的pH值会受到不同的影响。因为已知较低的pH值会损害局部防御机制，所以这些结果可能是腹腔镜检查中CO（2）的发生率高于其他气体的原因之一，正如文献报道的那样。

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