后腹腔CO2气腹对肾组织内皮素1表达影响.docVIP

后腹腔CO2气腹对肾组织内皮素1表达影响 　　[摘要] 目的 研究内皮素-1(ET-1)在后腹腔镜手术、开放手术后肾组织中的表达,探讨经后腹腔CO2气腹可能对肾脏组织的应激反应影响。方法 2007年1月～2008年2月30例无功能肾上腺腺瘤患者分为后腹腔镜手术组和开放手术组各15例,术中穿刺肾组织,采用免疫组织化学(SP)法检测ET-1的表达,并进行对照研究。结果 两组患者手术均获成功。后腹腔镜手术组肾组织ET-1阳性细胞表达强度积分为(1.58±0.20),表达数量积分为(1.82±0.27);开放手术组肾组织ET-1阳性细胞表达强度积分为(1.67±0.21),表达数量积分为(1.89±0.29),均较后腹腔镜手术组稍有增加,但差异无统计学意义(P0.05)。结论 常规压力下(13~15mmHg)后腹腔CO2气腹对肾脏组织的应激反应没有明显影响。 　　[关键词] 后腹腔;气腹;肾脏;免疫组织化学;内皮素-1 　　[中图分类号] R61;R446.62 [文献标识码] A [文章编号] 1673-9701(2010)14-03-03 　　 　　Influence of Retroperitoneal CO2 Pneumoperitoneum on Renal Endothelin -1 Expression 　　LIU Yong1FAN Tianyong2WEI Qiang2 　　1.Department of Urology,the 903 Hospital of Jiangyou,Jiangyou 621700,China;2.Department of Urology,West China Hospital of Sichuan University,Chengdu 610041,China 　　 　　[Abstract] Objective To investigate the renal endothelin-1 expression in retroperitoneal laparoscopic surgery and open surgery and explore the influence of retroperitoneal CO2 pneumoperitoneum on renal stress responses. Methods Thirty cases of non-functional adrenal adenoma from Jan. 2007 to Feb. 2008 were divided into the retroperitoneal laparoscopic adrenectomy group(15 cases) and the open adrenectomy group(15 cases), intraoperative renal biopsy was performed and the expression level of endothelin-1(ET-1) in renal tissue was detected by immunohistochemistry. Results All operations were successfully accomplished. The level and the proportion of ET-1 positive cell expression integral scores of the retroperitoneal laparoscopic group and open surgery group were(1.58±0.20)vs(1.67±0.21),(1.82±0.27)vs(1.89±0.29),respectively. There was no significant difference between the two groups(P0.05). Conclusion Retroperitoneal laparoscopic adrenectomy performed under the pneumoperitoneum pressure of 13~15mmHg has no effect on the renal stress response. 　　[Key words] Retroperitoneum;Pneumoperitoneum;Kidney;Immunohistochemistry;Endothelin-1 　　腹腔镜手术与传统开放手术相比,因其具有出血少、损伤小、对机体干扰轻、恢复快等特点,在多学科得以迅速发展[1]。目前泌尿系统腹腔镜已在我国广泛开展,且多