颈交感神经阻滞对复合伤大鼠小肠黏膜血流量及屏障功能的影响  

Influence of cervical sympathetic nerve block on blood flow volume and barrier function of intestinal mucosa after combined radiation and burn injury in rat

作　　者：涂柳[1] 方海立[2] 粟永萍[1] 艾国平[1] 李新[1] 李敏[1] 陈勇[1] 黄跃生[3] XU Jian-ming 

机构地区：[1]第三军医大学全军复合伤研究所,创伤,烧伤与复合伤国家重点实验室,重庆400038 [2]重庆医科大学基础医学院生理学教研室 [3]第三军医大学西南医院全军烧伤研究所,创伤,烧伤与复合伤国家重点实验室 [4]Department of Molecular Biology Baylor College Medicine

出　　处：《中华烧伤杂志》2007年第3期208-211,共4页Chinese Journal of Burns

基　　金：国家自然科学基金海外青年学者合作研究基金(30328025);创伤;烧伤与复合伤国家重点实验室开放课题(200305)

摘　　要：目的了解颈交感神经阻滞(SB)对放烧复合伤大鼠小肠黏膜血流量及屏障功能的影响。方法将SD大鼠分为正常组(18只)、复合伤组(100只)和复合伤+SB组(100只)。后2组制成5 Gy^(60)Coγ射线全身性照射+15%TBSAⅢ度烧伤的复合伤模型,并设伤后即刻和伤后1、3、5、7 d为观察时相点(每时相点20只大鼠)。复合伤+SB组在特定时间颈后双侧注射盐酸罗哌卡因致SB,复合伤组同法给予等量等渗盐水,不造成SB。检测各组大鼠不同时相点小肠黏膜组织血流量、肠绒毛高度及隐窝深度,并测定肠黏膜Na^+、K^+-腺苷三磷酸(ATP)酶活性和小肠通透性的变化。结果与正常组大鼠小肠黏膜血流量[(1.26±0.23)ml·min^(-1)·g^(-1)]比较,复合伤组明显下降[伤后1 d为(0.29±0.07)ml·min^(-1)·g^(-1),P<0.01],且绒毛高度显著降低、隐窝细胞大量破坏,肠黏膜Na^+、K^+-ATP酶活性下降和小肠通透性显著升高。与复合伤组各项指标比较,复合伤+SB组损伤程度有所减轻[小肠黏膜血流量伤后即刻为(0.82±0.11)ml·min^(-1)·g^(-1),P<0.01]。结论SB可增加放烧复合伤大鼠小肠黏膜血流量、促进肠上皮修复、改善肠道屏障功能。To investigate the influence of cervical sympathetic nerve block （SB） on blood flow volume and barrier function of intestinal mucosa after combined radiation and burn injury in rat. Methods SD rats were divided into three groups： control（ n = 18 ） ,combined injury group（ n = 100, rats with Co gamma ray body irradiation with a dose of 5 Gy plus 15% TBSA full-thickness burn injury） , and combined injury with SB treatment（ n = 100, with the same dose of γ-ray irradiation and burn injury ,treated with SB）. Twenty rats were sacrificed on 0,1,5,7 days after combined injuries for various observations. SB was conducted with injection of ropivhydrochloride into the neck bilaterally for the SB group,and same amount of normal saline was injected instead in the combined injury group. Blood flow volume, changes in villus height and crypt depth in jejunum, Na^＋ -K^＋ ATPase activity, permeability of small intestine were measured at different time-points. Results The blood flow volume in small intestinal mucosal on 1 post-injury days （PID） [ （0. 29 ＋ 0.07 ） ml · min^-1·g^-1 ] were obviously decreased than that in normal controls [ （ 1.26 ＋ 0.23 ） ml · min^-1 g^-1, p 〈0.011 ,with serious destruction of pit cells, decrease in intestinal mucosal Na^＋ -K^＋ ATPase activity, and increase in intestinal mucosal permeability. Compared with combined injury group, the blood flow volume was [ （0.82 ＋0. ll）ml·min^-1 · g^-1 1 day after combined injury, P 〈0.01 ] , and the Na^＋ -K^＋ ATPase activity was obviously increased , and the permeability of small intestine was ameliorated. Conclusion SB can increase blood flow volume of rat small intestine after combined radiation and burn injury,promote the repair of intestinal epithelium and improve the barrier function of the intestinal wall.

关 键 词：烧伤 辐射损伤 实验性 自主神经传导阻滞 小肠 血液循环 功能恢复 

分 类 号：R64[医药卫生—外科学] R574[医药卫生—临床医学]