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目的 研究腹部开放伤后海水浸泡对机体肠粘膜屏障功能的影响。方法 78只大鼠随机分为正常对照组 (NC组 ,n=6 )、手术对照组 (A组 ,n=18)、腹部海水浸泡组 (B组 ,n=18)、腹腔生理盐水浸泡组 (C组 ,n=18)及腹腔海水浸泡组 (D组 ,n=18)。观察各组动物处理前、处理后即刻、6 h、12 h血浆内毒素、肿瘤坏死因子 (TNF)、肠通透性 (血浆 D-乳酸 )及肠上皮细胞间紧密连接的变化。结果 A、B及 C组切开腹部致伤前及致伤后即刻、6 h、12 h血浆内毒素、TNF及 D-乳酸的含量变化均无显著性 (与NC组比较 P值均 >0 .0 5 )。而 D组海水浸泡后血浆内毒素、TNF及 D-乳酸含量均出现显著升高 (与NC、A、B、C组比较 P值均 <0 .0 5 ) ,浸泡结束后即刻血浆内毒素、TNF及 D-乳酸的含量分别为 (2 4 3.5± 85 .8) EU/L、(7.18± 1.2 0 ) ng/L、(49.2± 7.9) μmol/L,浸泡后 12 h测得值分别增至 (6 13.1±116 .4 ) EU/L、(10 .2 3± 0 .98) ng/L、(14 0 .7± 19.5 ) μmol/L。病理学检查出现小肠充血、淋巴细胞浸润及肠上皮细胞间紧密连接破坏等改变。结论 腹腔海水浸泡引起机体肠粘膜屏障功能损害。
Objective To study the effect of seawater immersion on intestinal mucosal barrier function after open abdominal wound. Methods 78 rats were randomly divided into normal control group (NC group, n = 6), operation control group (group A, n = 18), abdomen seawater immersion group (group B, n = 18) (Group C, n = 18) and intraperitoneal seawater immersion (group D, n = 18). The changes of plasma endotoxin, tumor necrosis factor (TNF), intestinal permeability (plasma D-lactate) and intestinal epithelial cells were observed before treatment, immediately after treatment, 6 h and 12 h after treatment. Results The levels of plasma endotoxin, TNF and D-lactate in group A, B and C before and after injury were significantly lower than those in NC group (P> 0.05) .0 5). However, the levels of plasma endotoxin, TNF and D-lactic acid in D group were significantly increased after immersed in seawater (P <0.05 compared with NC, A, B and C groups), plasma endotoxin, The contents of TNF and D-lactate were (EU2.4 ± 3.5) EU8.0 ± (7.18 ± 1.2) ng / L and (49.2 ± 7.9) μmol / L respectively (6 13.1 ± 116 .4) EU / L, (10.23 ± 0.98) ng / L, and (14 0 .7 ± 19.5) μmol / L, respectively. Pathological examination showed congestion of the small intestine, lymphocyte infiltration and intestinal epithelial cell junctions and other changes. CONCLUSIONS: Celiac seawater immersion causes damage to the intestinal mucosal barrier.