猪腹部肠管火器伤后肠源性内毒素血症与胃损伤  

Intestinal endotoxemia and gastric injury after intestinal perforations due to abdominal firearm wound

作　　者：史衍辉[1] 薛会朝[2] 夏璐[2] 刘江伟[2] 王云海[1] 

机构地区：[1]新疆医科大学,新疆乌鲁木齐830000 [2]兰州军区乌鲁木齐总医院,新疆乌鲁木齐830000

出　　处：《现代生物医学进展》2009年第19期3658-3660,共3页Progress in Modern Biomedicine

基　　金：兰州军区医药卫生科研基金资助项目(LXH-2005019)

摘　　要：目的:探讨腹部火器伤肠管穿透后胃的损伤性变化。方法:健康长白仔猪42头随机等分为对照组和腹部火器伤肠管穿透伤后1h、2h、4h、8h、12h和24h实验组。测定各组动物血浆内毒素,光镜下观察各组胃的组织形态学变化。结果:实验组各组血浆内毒素水平均明显高于对照组,内毒素于伤后8小时出现高峰,伤后12小时仍维持在高峰值水平(P<0.05);伤后各组出现逐渐加重的胃粘膜下充血、水肿,12h、24 h组出现炎细胞浸润、浆膜下出血。结论:腹部火器伤肠管穿透后,胃损伤性变化随时间延长而加重;肠源性内毒素血症在火器伤后继发性胃损伤中可能起重要作用。Objective：To investigate the dynamic changes of gastric injury after intestinal perforations due to abdominal firearm wound.Methods： A total of 42 Chang-Bai piglets were randomized into 7 groups：control group and wounded 1hour group,2hour group,4hour group,8hour group,12hour group,24hour group.Plasma endotoxin levels were determined.The alterations of gastric tissue were observed under light microscope.Results： Levels of plasma endotoxin in wounded groups were significantly elevated compared to control group, Plasma endotoxin levels of the experimental group were significantly higher than that of control group （P〈0.05）, 8 h after injury in the peak, 12 h after injury remained at peak levels. The experimental group appeared gradually aggravated gastric mucosa under hyperemia and edema under light microscope. Inflammatory cell infiltration and subserous hemorrhage were appeared in 12h and 24h group. Conclusion： The change of gastric injury is aggravated with prolongation of wound after intestinal perforations due to abdominal firearm wound. Intestinal endotoxemia may play an important role in secondery gastric injury of pigs.

关 键 词：腹部损伤 火器伤 胃损伤 内毒素 

分 类 号：R641[医药卫生—外科学] R826.5[医药卫生—临床医学]