庆大霉素肠管去污染对大鼠实验性胰腺炎时细菌易位的影响  

Value of intestinal decontamination by gentamycin in the prevention of bacterial translocation complicated by severe acute pancreatitis in rats

作　　者：卞建民[1] 井清源[1] 沈鸿藻 

机构地区：[1]南京医科大学附属南京第一医院普外科

出　　处：《中华普通外科杂志》1999年第2期89-90,共2页Chinese Journal of General Surgery

摘　　要：目的探讨庆大霉素对实验鼠肠管去污染预防重症胰腺炎并发胰腺感染性坏死的效果。方法经胰胆管插管注射无菌的５％牛磺胆酸钠制成大鼠重症胰腺炎模型。大鼠分成重症胰腺炎组（１组）；轻型胰腺炎组（２组）；重症胰腺炎加盲肠给予庆大霉素组（３组）；重症胰腺炎加庆大霉素肌肉注射组（４组）和实验对照组。术后观察各组大鼠回肠系膜淋巴结、胰腺、肝脏和血液的肠源性细菌培养阳性率。结果实验后７２小时，１组大鼠（１１只）肠系膜淋巴结培养阳性率为１００％（１１／１１），胰腺和肝脏分别为８２％（９／１１）和２７％（３／１１），但血液培养阴性。２组（１０只）大鼠肠系膜淋巴结培养阳性仅３０％（３／１０），余器官培养结果均为阳性；３组（１２只）肠淋巴结和胰腺组织培养阳性率分别为４２％（５／１２）和３４％（４／１２）；而４组大鼠肠淋巴结、胰腺、肝脏和血液培养阳性率依次为１００％（１１／１１）、９１％（１０／１１）、９％（１／１１）、９％（１／１１）。结论经肠管直接给予庆大霉素去污可降低重症胰腺炎感染并发症，经肌肉注射则否。Objective To evaluate the effect of gentamycin decontamination in proventing the necrotic infection of the pancreas in severe acute pancreatitis (SAP).Methods Rats were divided into five groups:1.SAP;2.Mild pancreatitis (MAP); 3.SAP + gentamycin given by cecum; 4.SAP + gentamycin given by im injection and 5. Control group.Pancreatitis was induced by intrapancreatic duct injection of 5% (in SAP group) or 3% (in MAP group) of sterile sodium taurocholate at a dosage of 1 ml/kg body wt.The cecums of the rats were fixed subcutaneusly one week before the experiment for preventing abdominal contamination.The positive incidence of enteral bacteria cultured from pancreas,mesocecum lymph nodes (MLN),liver and blood samples were observed.Results 72 hours after the experiment,bacteria were found in the MLNs in 100%(11/11),in 82% in pancreatic parenchyma and 27% of the liver,respectively in group 1.The MLNs in group 2 were positive in only 30%,and no bacteria showed in other organs;The incidence of positive culture from the MLNs and pancreatic tissue in group 3 (n=12) was 42% and 34%;Finally,the MLNs,pancreas,liver and blood in group 4 animals (n=11) showed 100%,91% ,9% and 9% of enteral bacteria positive rate.Conclusions Gentamycin decontamination was effective in preventing bacterial translocation complicated by SAP only by route of cecum not by intramuscular injection in experimental SAP rats.

关 键 词：胰腺炎 庆大霉素 细菌易位 大鼠 

分 类 号：R657.51[医药卫生—外科学] R978.12[医药卫生—临床医学]