Effect of Pressure-Controlled Inverse Ratio Ventilation on WBC, PCT and CRP in Rats Undergoing Radical Gastrectomy and Related Mechanism

LI Chun-yang; PENG Xiao-hui; WAN Hui-lai; ZHENG Yue

摘要：Objective: To explore the effect of pressure-controlled inverse ratio ventilation on partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), dynamic lung compliance (Cdyn), white blood cell (WBC), procalcitonin (PCT), C-reactive protein (CRP), and other indicators. Methods:A total of 100 healthy Wistar rats, aged 6-8 weeks and weighing 300-356 g, were used to establish gastric cancer models with 1-methyl-3-nitro-1-nitrosoguanidine (MNNG). 60 gastric cancer rats were randomly divided into three groups and treated with laparoscopic radical gastrectomy after anesthesia. Rats in the VCV group were given volume control ventilation, rats in the PCV group were given pressure control ventilation, and rats in the PC-IRV group were given pressure control inverse ratio ventilation. The levels of WBC, PCT and CRP in the three groups were observed and compared on the 1st, 3rd and 5th day after operation. Results: There were significant differences in PaO2 levels at 15 min after ventilation mode change and at the time of pneumoperitoneum closure, and in PaCO2 and Cdyn levels at 10 min after induction and at 15 min after ventilation mode change among the three groups (P＜0.05). The PaO2 levels in PC-IRV group were higher than those in VCV group and PCV group at 15 min after the ventilation mode was changed and at the time of closing the pneumoperitoneum. The level of PaCO2 in PC-IRV group was lower than that in VCV group and PCV group 10 min after induction and 15 min after ventilation mode change, and the level of PaCO2 in PC-IRV group was lower than that in VCV group when pneumoperitoneum was turned off. The level of Cdyn in PC-IRV group was higher than that in VCV group and PCV group at 10 min after induction and 15 min after ventilation mode change. The level of Cdyn in PC-IRV group was higher than that in PCV group at the time of closing pneumoperitoneum. The Cdyn level in PCV group was lower than that in VCV group at 15 min after ventilation mode change. There were significant differences in WBC levels among the three groups on the 1st day after operation (P＜0.05), and there were no significant differences in PCT and CRP levels among the three groups on the 1st day after operation ( P＞0.05).There were significant differences in WBC, PCT and CRP levels in the three groups of rats on the 3rd and 5th days after surgery (P＜0.05). Except for PCT and CRP on the 1st day after operation, the WBC on the 1st, 3rd and 5th days after operation, PCT and CRP on the 3rd and 5th days after operation in PCV group and PC-IRV group were lower than those in VCV group (P＜0.05). Except for WBC, PCT and CRP on 1st day after operation, the levels of WBC, PCT and CRP on the 3rd and 5th days after operation in PC-IRV group were lower than those in PCV group (P＜0.05). Conclusion: During laparoscopic radical gastrectomy for gastric cancer, pressure-controlled inverse ratio ventilation can help rats maintain good respiratory status and lung compliance during the operation, which can effectively alleviate the postoperative inflammatory response.