The Influence Of High Intraabdominal Pressure Towards Multi-internal Organs And The Intervention Of Large Chengqi Decoction

Purpose:To observe different level of lintra-abdominal pressure (IAP)'s influence towards the hepatorenal and lung function and the intervention of the Large Chengqi Decoction.Methods:taken suction blood sample through the animals'right flank femoral artery and femoral vein,and then detected blood gas analysis, Hepatic function and renal function;after the performance of the abdominal paracentesis with trocar,link trocar and manometer, trocar and Storage cylinder with T-tube, respectively.we choose-d 57 healthy New Zealand rabbits,and divided them into three groups:the experimental group(27), the traditional Chinese medicine group (27)and the normal control group (27), respectively.Divided the front two groups into three groups,respectively,by IAP of 10,15 and 20mmHg.The duration of pressure of 10,15 and 20mmHg were defined as three phase:1,2,3.5hours,respectively, each group of 3.After finishing the third phsae(3.5hours),we get the liver,kindey and lung tissue to perform pathology analysis.Result:1.Related Laboratory index of each group:compared to the normal control group: at the identical pressure level,the transaminase (AST,ALT) increased followed the duration extension;Additionaly,in the identical phase, the transaminase (AST,ALT) increased followed the rise in pressure. Creatinine(Cr) and urea nitrogen(UN) weren't detectde obvious change.when we holded the IAP10mmHg for 1h,the PaO2 had a obvious drop,but PaCO2,SaO2 and Ph value of blood didn't change remarkablely; when holding IAP20mmHg for 1h,compared to the normal control group,we detected a remarkable drop. 2.Compared to the normal control group:under the IAP of 10mmHg,the AST of the traditional Chinese medicine group inceeased followed the duration extension; but under the IAP of 15and20mmHg,we didn't detect a remarkable rise in the AST;under the same IAP,the ALT dropped followed the duration extension,creatinine(Cr) and urea nitrogen(UN) weren't detectde obvious change;under the IAP of 10 and 15mmHg,the PaO2,SaO2 and Ph value of blood had no obvious change; under the IAP of 20mmHg, the PaO2,SaO2 and Ph value of blood dropped obviously, but the Pco2 rised remarkablely.3.Compared to the experimental group:in the identical condition(pressure and phase), the level of AST of the traditional Chinese medicine group was much higher;meanwhile,in thesame phase, the higher IAP,the more remarkable discrepancy of AST between above two groups;under the same IAP,the discrepancy presented diminished——augmented in order followed the duration extension; Cr and UN weren't detectde obvious change;under the IAP of 10 and 15 mmHg, the PaO2 of the experimental group dropped obviously;under the IAP of 20 mmHg, PaO2, SaO2, Pco2 and Ph value of blood of the traditional Chinese medicine group weren't detected obvious change.4. Pathological changes of organs:(1).lung:with the increase of intra-abdominal pressure, alveolus'structure becomes obfuscation, alveolar septum is widened gradually, congestion and hydroncus is worse,more and more exudation appears in the alveolar space,whose major content is akaryocyte; compared with the same pressure,the group using the drug improved a lot.(2).liver:with the increase of intra-abdominal pressure, central veins and sinus hepaticus broadened obviously, akaryocyte increased gradully, the hydroncus of hepatocyte became worse, volume of which became bigger, at the lever of 20mmHg, some part of hepatocyte were necrosis, compared with the same pressure,the group using the drug improved a lot.(3). kidney:with the increase of intra-abdominal pressure, the bleeding of acinus renis worsened, the hydroncus of nephric tubule is aggravated gradully, at the lever of 20mmHg,part of the acinus renis and nephric tubule were necrosis, nephron decreased; compared with the same pressure,the group using the drug improved little.Conclusion:1.The increased Intra-abdominal pressure is harmful to liver function,the extent of damage in liver function is proportional with the endo-abdominal pressure and action time;The addition and subtraction of soup can protect the liver function,and higher pressure induced more obvious protection.2. the critical value of Intra-abdominal pressure is 20mmHg,under which it would be no harmfulness to renal function.3. The increased Intra-abdominal pressure can obviously result in hyoxemia, hypercarbia and metabolic acidosis, The addition and subtraction of soup can protect the lung function and improve the hyoxemia.