腹部开放伤后海水浸泡对犬肠功能及形态学的影响  

Effects of seawater immersion on intestinal function and pathomorphology in dogs with open abdomen injury

作　　者：孙涛[1] 李欣[1] 金博[1] 刘超群[1] 浦江[1] 付山峰[1] 段蕴铀[2] 

机构地区：[1]海军总医院消化内科,北京100037 [2]海军总医院院办,北京100037

出　　处：《中华航海医学与高气压医学杂志》2007年第5期261-264,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：海军重点课题（06-3304）

摘　　要：目的探讨腹部开放伤后海水浸泡对实验犬肠功能及其形态学的影响。方法实验动物致伤后随机分为对照组（10只）和海水浸泡组（10只）。对照组致伤后直接观察，海水浸泡组致伤后放人海水中浸泡1．5h。于致伤前（0h）及出水后4、8、12、16、20h取血测定血清内毒素、谷氨酰胺、乳酸、肿瘤坏死因子一d（TNF—d）、白介素-6（IL-6）含量，测量腹围，监测肠鸣音。进行大便常规及潜血检查，记录呕血和黑便的发生率，24h取小肠组织进行病理检查。结果海水浸泡组24h均死亡，对照组无死亡。血清内毒素、乳酸、TNF—α和IL-6升高并且呈进行性发展，谷氨酰胺出现进行性下降，20h指标与对照组比较差异有统计学意义。海水浸泡组大便常规及潜血检查出现阳性，与对照组相比差异有统计学意义，并有6只犬出现黑便，1只出现呕血；腹围增加，肠鸣音减弱，与对照组相比差异有统计学意义；小肠病理检查有明确的形态学改变，对照组病理变化不明显。结论海水浸泡可导致实验犬的肠道屏障功能损伤和小肠细胞病理形态学变化，海水浸泡组还可出现消化道出血以及肠麻痹，原因可能与肠道菌群移位、海水直接损伤等因素有关。Objective To evaluate effects of seawater immersion on the intestinal function and pathomorphology in dogs after open abdomen injury. Methods Twenty healthy dogs were randomized into 2 groups：seawater immersion group （n = 10 ） were immersed in seawater after induced abdomen trauma and control group（n = 10） were studied directly. Blood samples were taken before and after trauma,contents of endotoxin, glutamine, lactic acid,TNF-α and IL-6, abdominal circumference and bowel sound were determined at interval time, respectively. Furthermore, manure was assayed by routin and occult blood methods. Then incidence rate of hematemesis and melena was recorded. Intestinal tissue was also tested for pathological examination at 24 hour. Results All dogs in seawater immersion group died after 24 hours but those in control group survived. In seawater immersion group the content of endotoxin, lactic acid ,TNF-α and IL-6 was increased and glutamine was decreased continously, which was significantly different from those of control group after 20 hours. Positive results in the routine and occult blood of dung tests were significantly different. Six dogs suffered from hematemesis and one had pain in melena. Increased abdominal circumference and weakening bowel sound in seawater immersion group was significantly different from those in control group. Pathological changes in intestinal tissue in seawater immersion group were much more significiant than those in control group. Conclusions Seawater immersion can lead to the injury of intestinal barrier function and the pathological changes of intestinal cells. Dogs in seawater immersion group can also occur gastrointestinal bleeding and intestinal paralysis by reasons of intestinal flora translocation, direct injury of seawater and so on.

关 键 词：海水浸泡 腹部开放伤 肠功能 病理学 

分 类 号：R6[医药卫生—外科学]