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目的 通过建立大鼠肿瘤动物模型 ,探讨腹腔镜手术中常用的气腹介质CO2 对径路口及腹腔内肿瘤细胞转移的影响。方法 手术前 1h于 30只Wistar大鼠腹腔内注入R15肝癌细胞株 ,然后随机将大鼠分为 3组 :免气腹组 ( n =10 )、剖腹组 ( n =10 )、CO2 气腹组 ( n =10 ) ,实验维持 2h ,2 8d后宰杀动物比较各组径路口及腹腔内的肿瘤转移。结果 CO2 气腹组、剖腹组及免气腹组在径路口、肠浆膜层、肠系膜、大网膜和膈肌等部位转移的肿瘤重量分别为 ( 32 6 .7± 2 30 .3)mg、( 181.6± 174.7)mg和 ( 2 9.0± 6 2 .8)mg( P <0 .0 5或P <0 .0 1) ;( 6 2 6 .2± 2 15 .9)mg、( 2 71.5± 2 19.2 )mg和 ( 44.3± 10 0 .1)mg( P <0 .0 5或P <0 .0 1) ;( 476 .2± 2 0 4.8)mg、( 184.0±187.1)mg和 ( 42 .5± 96 .7)mg( P <0 .0 5或P <0 .0 1) ;( 2 5 36 .5± 90 6 .6 )mg、( 112 9.1± 933 .9)mg和 ( 15 9.5± 35 4.4)mg( P <0 .0 5或P <0 .0 1) ;( 346 .1± 186 .4)mg、( 16 9.1± 16 2 .1)mg和( 11.3± 35 .7)mg(P <0 .0 5或P <0 .0 1)。结论 腹腔镜手术中的常用气腹介质CO2 是导致肿瘤细胞在径路口及腹腔内转移的主要原因。
OBJECTIVE: To establish an animal model of tumor in rats and investigate the effect of pneumoperitoneum CO2 commonly used in laparoscopic surgery on the metastasis of tumor cells at the crossing and in the abdominal cavity. Methods Thirty Wistar rats were injected intraperitoneally with R15 hepatoma cell line 1h before surgery. The rats were then randomly divided into three groups: pneumoperitoneum (n = 10), laparotomy (n = 10), CO2 pneumoperitoneum (n = 10). The animals were sacrificed 2 hours and 28 days later to compare the tumor metastasis in each group of trail and intraperitoneal cavity. Results The tumor weights of CO2 pneumoperitoneum group, laparotomy group and pneumoperitoneum group were (32 6 .7 ± 2 30 .3) mg, respectively, at the junction of the gut, serosa, mesentery, omentum and diaphragm, (181.6 ± 174.7) mg and (2 9.0 ± 62.8) mg (P <0.05 or P <0.01); (62.6 ± 2 15.9) mg and (2 71.5 ± 2 19.2) mg and (44.3 ± 10 0 .1) mg (P <0.05 or P <0.01); (476 ± 2 ± 4.8) mg, (184.0 ± 187.1) mg and 42.5 ± 96.7) mg (P <0.05 or P <0.01); (2 5 36.5 ± 90 6 .6) mg, (112 9.1 ± 933.9) mg and ( 15 9.5 ± 35 4.4) mg (P <0.05 or P <0.01); (346.1 ± 186.4) mg, (16 9.1 ± 16 2 .1) mg and (11.3 ± 35. 7) mg (P <0.05 or P <0.01). Conclusions CO2 pneumoperitoneum commonly used in laparoscopic surgery is the main reason leading to the metastasis of tumor cells in the pathways and intraperitoneal pathways.