【摘要】 目的观察二氧化碳(CO2)气腹对大鼠肠道运动功能以及肠神经系统内乙酰胆碱酯酶(AchE)神经元和一氧化氮合酶(NOS)神经元的影响,探讨CO2气腹影响肠道神经运动功能的机制。方法36只SD大鼠随机分为实验组(n=24)和对照组(n=12),实验组再根据气腹持续时间不同分为气腹30min组和气腹60min组(n=12)。各组术后灌服炭末,测定小肠炭末推进率,同时取各组相同部位的小肠,制作肠肌间神经丛铺片标本,采用AchE和NADPH-d组化染色,比较各组AchE、NOS阳性神经元的分布密度和染色情况。结果气腹60min组的炭末推进率(28.55%±3.45%)明显低于气腹30min组和对照组(45.90%±6.30%,48.25%±5.28%,P<0.01),气腹30min组和对照组比较降低不明显(45.90%±6.30%,48.25%±5.28%,P>0.05)。小肠肌间神经丛内AchE阳性神经元数量,气腹60min组(48.00±3.16)明显少于气腹30min组和对照组(58.82±4.62,61.83±4.17,P<0.01),阳性表达减弱;气腹30min组与对照组比较,AchE阳性神经元数量和阳性表达的变化均不明显(P>0.05)。小肠肌间神经丛内NOS阳性神经元数量,气腹60min组(42.17±4.45)明显多于气腹30min组和对照组(32.50±4.34,30.83±3.66,P<0.01),阳性表达增强,节间束纤维粗大,而气腹30min组和对照组比较,NOS阳性神经元数量和阳性表达的变化不明显(P>0.05)。结论持续较长时间的CO2气腹会影响或损害肠神经系统的胆碱能和氮能神经功能,这可能是气腹后肠道运动功能障碍发生的神经机制之一。更多还原

【Abstract】 Objective To observe the effects of CO2 pneumoperitoneum on the enteric motor function and acetylcholine esterase(AchE) neuron and nitric oxide synthase(NOS) neuron in the enteric nervous system,and explore the neuromechanism of the CO2 pneumoperitoneum on renteric motor function.Methods Thirty-six Sprague Dawley rats were randomly divided into experiment group(n=24) and control group(n=12).The experiment group was divided into two subgroups namely pneumoperitoneum 30min group and pneumoperitoneum 60min group(12 each) based on the maintenance time of pneumoperitoneum.Rats in each group were gavaged with medicinal carbon powder,and then the transmission of carbon powder in small intestine was determined.The spreading specimens of intestinal myenteric plexus of small intestine were prepared and the stained AchE and NOS neurons were observed and compared.Results The propellant velocity of carbon powder was slower in pneumoperitoneum 60min group than that in pneumoperitoneum 30min group and control group(28.55%±3.45% vs 45.90%±6.30%,48.25%±5.28%,P<0.01).No significant difference of the propellant velocity was found between pneumoperitoneum 30min group and control group(45.90%±6.30% vs 48.25%±5.28%,P>0.05).The number of positive expression of AchE neurons in intestinal myenteric plexus decreased in pneumoperitoneum 60min group compared with that in pneumoperitoneum 30min group and control group(48.00±3.16 vs 58.82±4.62,61.83±4.17,P<0.01),while no significant difference was found between pneumoperitoneum 30min group and control group(58.82±4.62 vs 61.83±4.17,P>0.05).The number of positive expression of NOS neurons in intestinal myenteric plexus increased in pneumoperitoneum 60min group compared with that in pneumoperitoneum 30min group and control group(42.17±4.45 vs 32.50±4.34,30.83±3.6,P<0.01),and the cell bodies were deeply stained,positive nerve fibers between ganglia were bigger,and there was no significant difference between pneumoperitoneum 30min group and control group(32.50±4.34 vs 30.83±3.66,P>0.05).Conclusions Prolonged CO2 pneumoperitoneum can affect or damage cholinergic neurons and nitroxidergic neurons in the enteric nervous system to some extent,and it may be the underlying mechanism of the intestinal motor dysfunction after operation.更多还原