ABSTRACT
Objective To explore the clinical effect of tumescent anaesthesia in laparoscopic cholecystectomy(LC). Methods We analyzed the data of 71 patients who underwent LC for gallbladder benign disease. Anesthesia swelling fluid was injected in 37 cases before the operation in the gallbladder triangle( group D)and another 34 cases received no injection(group C). SBP,DBP,HR and Spo2 were monitored at 4 min before gallbladder traction(T1),1 min(T2),6 min(T3)and 11 min after gallbladder traction(T4),and when the gallbladder was dissected from gallbladder bed completely(T5). The operation time,intraoperative blood loss,postoperative exhaust time,time of getting out of bed after the surgery and length of stay were recorded. The gallbladder rupture, vascular injury ,bile duct injury ,intestinal injury ,placement of drainage tube ,intra-abdominal hemorrhage , intraoperative use of atropine or ephedrine and nausea and vomiting 24 hours after the operation were recorded. Results In group C,SBP,DBP and HR were significantly decreased at T2-T4 when compared with those at T1, and were significantly lower when compared with those in group D(P < 0.05). There was no significant difference in oxygen saturation between the two groups(P > 0.05). There were shorter operation time and less intraoperative blood loss in group D when compared with those in group C and the difference was statistically significant (P <0.05). The anus exhaust time,time of getting out of bed after the surgery,length of stay,intraoperative intra-abdominal hemorrhage and nausea and vomiting in the two groups indicated no statistical significance (P > 0.05). Gallbladder damage,vascular injury,placement of drainage tube and the incidence of adverse event were less in group D than those in group C. Conclusion Swelling anesthesia in LC can shorten the operation time ,induce less postoperative complications and maintain blood circulation stability.
ABSTRACT
Objective To study the pretreatment with prostaglandin E1 ( PGE1 ) on acute superior mesenteric ar-tery ( SMA) ischemia reperfusion injury of intestinal cell in rats. Methods 18 healthy male SD rats were randomly divided into control group, sham operation group and experimental group. IRI of SMA model was made by clamping the SMA for one hour and two hours after reperfusion in the control group and the experimental group,respectively. PGE1(20 μg/kg) was injected from the tail vein in the control group and the experimental group. Character of pa-thology of small intestine was examined. The expression of Bax and Bcl-2 in small intestine cells and change of IF-ABP and DAO in serum were detected. Results Pathologic changes showed that there was no change in the control group;while in the sham operation group,chorionic epithelium mucosa ulceration and hemorrhage and necrosis oc-curred more seriously than that in the experimental group. Expression of Bax and Bcl-2 was higher in the sham op-eration group and the experimental group than that in the control group(P<0. 05), and it was obviously lower in the experimental group than in the sham operation group(P<0. 05). The content of IFABP and DAO in blood ser-um:it was higher in the sham operation group and the experimental group than in the control group ( P<0. 05 ) , and it was lower in the experimental group than in the sham operation group(P<0. 05). Conclusion PGE1 can relieve the alvine necrosis caused by rats' mesenteric reperfusion injury after acute artery ischemia and thus protect damaged mucosa of small intestine.