Relation Of The Effect On The Liver With The Changes Of Intra-abdominal Pressure Gradient

Objectives:The change of the Intra-abdominal pressure gradient cause liver energy metabolism changes and ischemia-reperfusion injury. This experiment from cytology perspective study the rabbit liver cell damage influence and hepatic artery pressure change with intra-abdominal pressure gradient change from cytology perspective, to provide the guidance about protection and therapy of the patients whose clinical intraperitoneal pressure gradient is elevated.Methods: The 54 rabbits were randomly divided into the control group 6, the experimental group 48. The experimental group and control group are conducted in the right quarter of ribs and take vessels of portal vein catheterization. And make a dynamic observation of portal vein pressure and blood specimen collection. Then close the abdominal cavity. Close the abdominal cavity in the control group after surgery. Establish pneumoperitoneum in the experimental group, and take N2 gas slowly into the abdominal cavity on rabbits to produce rabbit animal model of intra-abdominal pressure gradient changing. Dynamically detect the changes in intra-abdominal pressure gradient to keep intra-abdominal pressure gradient remained relatively constant, respectively, collecte rabbit portal vein blood samples in 10,20 mmHg at different time points under pressure (0.5h, 1h, 1.5h, 2h). Detect the parameters of liver cell injury [serum prealbumin (PA), heat shock protein (HSP-70)] by Elisa, and use the PT-100 pressure transducer to measure the change of portal vein pressure,observe the liver pathologic changes.Result:1. The parameters of the liver cell injury: Between the control groups and the experimental groups in the same pressure gradient, the longer times extend, the more pre-albumin decreased and the more obvious increase in heat shock protein; at the same time, the higher the pressure gradient will be, the more pre-albumin decreased and the more obvious increase in heat shock protein. Take an analysis by SPSS13.0, if P <0.05, there will be Statistically significant difference.2. Hepatic arterial pressure are different In different peritoneal pressure gradient. Hepatic arterial pressure is 14.4±1.7 kPa in the normal control group, the hepatic arterial pressure is 9.9±1.2 kPa in the pressure gradient group of 15mmHg intra-abdominal, the hepatic arterial pressure is 20mmHg group 8.3±0.8 kPa in the pressure gradient group of intra-abdominal. Take an analysis by SPSS13.0, if P <0.05, there will be Statistically significant difference.3. The liver pathology: In different peritoneal pressure gradient the liver damage is different. With the increase of intra-abdominal pressure gradient, the liver damage is more severe, central venous and sinus will be oppressed, so that the expansion became clear. The leakaged red blood cells increase gradually, the liver cells edema and increase, and the volume of liver cells increases. With the time and the pressure gradient increases, the visible portion of the part liver cells necrosis.Concusion: The rabbit liver cells and portal vein pressure was affected by intra-abdominal pressure gradient. When the IAP> 10 mmHg there may be damage and variability. When the IAP> 20 mmHg, there may be irreversible necrosis, and lead to irreversible liver damage. The higher intra-abdominal pressure gradient will be, the longer duration of action will be, the more serious of the liver damage will be.