The effect of different levels of peritoneal CO2 pressure on bleeding time of spleen capsule injury
The effect of different levels of peritoneal CO2 pressure on bleeding time of spleen capsule injury
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不同腹腔CO2压力水平对脾被膜损伤出血时间的影响
DOI：
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
Ö. Horváth
中科院分区：
文献类型：
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作者：
A. Papp;.. Vereczkei;J. Lantos;Ö. Horváth
目的：与开放手术中的类似损伤相比，作者观察到了在腹腔镜手术中相对较大的脾被膜损伤的自发止血。方法：5只麻醉杂种犬在不同二氧化碳分压下和开放手术中造成标准脾损伤。每分钟通过擦拭伤口周围而不是清除血块来检查出血。测量出血时间，直到不再渗出为止。在每个压力水平下进行3-3次测量并进行分析。采用直接置管法检测脾实质压和全身血压。结果：开放手术平均出血时间为15.2min，二氧化碳分压为5、15、25 mm Hg时，平均出血时间分别为12.3、10.6、9.8min。脾实质压(5~6 mm Hg)与腹膜压同步升高，但全身血压无明显变化。结论：腹膜二氧化碳分压可抵消脾实质压力，有助于止血。腹膜压力和出血时间似乎成反比。在腹腔镜术中脾被膜损伤的情况下，自发性止血的机会比开腹手术要好得多。必须注意保持足够的腹膜压力。
Aims: The authors, in contrast to similar injuries with open surgery, had observed spontaneous hemostasis of relatively large spleen capsule injuries during laparoscopic surgery. Methods: Standard spleen injuries were carried out in 5 anesthetized mongrel dogs at different CO2 pressures and in open surgery. Bleeding was checked every minute by wiping around the injury but not removing the clot. Bleeding time was measured until no more oozing was detected. At every pressure level 3-3 measurements were done and analyzed. Parenchymal pressure of the spleen and systemic blood pressure were detected with direct catheter implantation. Results: In open surgery the average bleeding time was 15.2 min; at 5, 15, and 25 mmHg CO2 pressures bleeding times were 12.3, 10.6, and 9.8 min, respectively. The parenchymal pressure of the spleen (5–6 mmHg) rose synchronously with peritoneal pressure, but no significant changes in systemic blood pressure were seen. Conclusion: Peritoneal CO2 pressure may counterweight the parenchymal pressure of the spleen, thus helping hemostasis. There seems to be an inverse proportion between peritoneal pressure and bleeding time. In case of spleen capsule injury during laparoscopic surgery, chances for spontaneous hemostasis are much better compared to open surgery. Attention must be paid to maintain adequate peritoneal pressure.
腹腔内吹入二氧化碳和腹内压升高对术后胃肠道转运的影响：小鼠实验研究。
影响因子：
2.4
作者：
Bustorff-Silva,J;Perez,CA;Atkinson,JB;Raybould,HE
通讯作者：
Raybould,HE