بررسی تغییرات هیستومورفولوژی کلیه، کبد، پانکرآس و طحال در افزایش فشار گاز دی اکسید کربنیک در طی اعمال جراحی لاپاراسکوپی در سگ
محورهای موضوعی : پژوهش های بالینی دام های بزرگ
کلید واژه: دی اکسید کربن, کبد, کلیه, طحال, لاپاراسکوپی, فشار داخل صفاقی, پانکرآس,
چکیده مقاله :
دمیده شدن ممتد یک گاز بی اثر به داخل حفره صفاقی در حین لاپاراسکوپی شرایط کاری را برای جراح راحت‌تر می‌کند. حجم این گاز باید به اندازه کافی زیاد بوده تا جراح دید کافی داشته باشد اما نباید از حد استاندارد آن (15 میلی متر جیوه) فراتر رود. متداولترین گازی که بدین منظور استفاده می‌شود دی اکسید کربن است زیرا این گاز اجازه انجام الکتروکوتری بی خطر را داده و به سرعت در عروق خونی جذب و حل می‌شود، بنابراین خطر امبولیسم گاز را کاهش می‌دهد. بیست قلاده سگ ماده از نژاد مخلوط برای این مطالعه آماده شدند. وزن متوسط آنها 3 ±20 کیلوگرم و سن متوسط آنها 2/1 ± 18 ماه بود. سگ ها به صورت تصادفی به دو گروه 10 تایی تقسیم شدند. در گروه کنترل فشار داخل شکمی در حد 12 میلی متر جیوه و در گروه آزمایش در حد 20 میلی متر جیوه نگه داشته شد. طول مت جراحی (زمان وجود گاز در حفره شکمی =4 ساعت) در نظر گرفته شد. ارزیابی هیستوپاتولوژی، تغییرات آسیب شناسی بیشتری را در کلیه تمام سگ‌های گروه آزمایش نشان داد. یافته‌های ما نشان داد ارگان هایی که رسانش خونشان توسط یک یا دو سرخرگ و بازگشت خونشان توسط یک یا دو سیاهرگ تامین می‌شود، به افزایش فشار داخل حفره بطنی بسیار حساس ترند.
During laparoscopy, a working space is established by continuous insufflating an inert gas in the peritoneal cavity whose volume should be large enough to facilitate surgery without increasing intra-abdominal pressure (IAP) over a threshold limit (usually 15 mm Hg). The most commonly used gas is CO2, since it permits safe electrocautery and is rapidly absorbed and dissolved into blood, thus minimizing the risk of gas embolism. Twenty female mixed breed dogs which chose for an experimental procedure were prepared. Average of weight was 20 ± 3 kilograms and average recorded of age was 18 ± 1.2 months. They randomly divided to two groups (n10). In control group the intraabdominal pressure was maintained 12 mm/Hg and in test group 20 mm/Hg during the operation. Histopathologic evaluations revealed more pathological changes at the kidney of all the dogs in test group (intraabdominal pressure: 20 mm/Hg) in comparison to control group (intraabdominal pressure: 12 mm/Hg). Findings showed that, the organs with fewer numbers (1 or 2) of arteries and veins are more susceptible to increased intra-abdominal pressure.
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