硬膜外输注吗啡镇痛对兔结肠Cajal间质细胞数量的影响  

Effect of epidural morphine for analgesia on the number of interstitial cells of Cajal in rabbit colon

作　　者：杨恒[1] 谭婧[2] 骆宏[1] 金孝岠[3] 

机构地区：[1]合肥市第一人民医院麻醉科,230061 [2]江苏省肿瘤医院麻醉科 [3]皖南医学院弋矶山医院麻醉科

出　　处：《中华麻醉学杂志》2013年第4期448-450,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨硬膜外输注吗啡镇痛对兔结肠Cajal间质细胞（ICC）数量的影响。方法健康家兔30只，雌雄不拘，体重2．0～2．5kg，采用随机数字表法，将其分为2组（n=15）：对照组（c组）和吗啡组（M组）。2组行硬膜外穿刺置管，M组每天硬膜外输注吗啡9．2扯g·kg-1·h-1，C组输注等容量生理盐水，连续输注7d。给药期间记录粪便性状，记录便秘的发生情况。停止给药后1d时经口插胃管灌人生理盐水和中华墨汁混合液5ml，30min后处死，开腹，取幽门至回盲部肠管，在无张力状态下测量幽门至回盲部肠管长度及墨汁在肠道的推进距离，计算小肠推进率；取近端和远端结肠组织，采用免疫组化法测定c-kit表达；行HE染色，光镜下观察病理学结果，进行ICC计数。结果与C组比较，M组吗啡给药3～7d时便秘发生率升高，小肠推进率降低，近端结肠c—kit表达和ICC计数降低（P〈0．05），远端结肠c-kit表达和ICC计数差异无统计学意义（P〉0．05）。结论硬膜外输注吗啡镇痛可抑制兔肠运动功能，其机制与降低近端结肠ICC数量有关。Objective To investigate the effect of epidural morphine for analgesia on the number of inter- stitial cells of Cajal （ICC） in the rabbit colon. Methods Thirty healthy rabbits of either sex, weighing 2.0-2.5 kg, were randomly divided into 2 groups （n = 15 each）： control group （group C） and morphine group （group M） . The animals were anesthetized with iv 20% urethane 4 ml/kg. The epidural analgesia was performed at L3,4 interspace. In group M morphine 9.2 μg.kg-1 . h-1was infused into the epidural space for 7 consecutive days, while the equal volume of normal saline was infused instead in group C. The characteristics of excrement and con- stipation were recorded during morphine infusion. Normal saline or Chinese ink mixture 5 ml was administered via a gastric tube inserted through the mouth 1 day after the end of administration. The rabbits were sacrificed 30 min later and laparotomy was performed. The intestinal segment numbered from the pylorus to the ileoeecal region of the bowel was removed and the length of the intestinal segment and propelled distance of the ink within the intestinal tract were measured in the tension-free state. The rate of propelled distance was calculated. The proximal and dis- tal colon tissues were taken for measurement of the expression of e-kit （by immunohistoehemisty） and ICC count, and stained with haematoxylin and eosin for examination of pathological changes. Results Compared with group C, the incidence of constipation was significantly increased, and the rate of propelled distance, and expression of c-kit and ICC count in proximal colon tissues were decreased at 3-7 days of morphine infusion （ P 〈 0.05）, and no significant change was found in the expression of c-kit and ICC count in distal colon tissues in group M （ P 〉 0.05 ）. Conclusion Epidural morphine for analgesia can inhibit the motor function of the intestinal tract in rab-bits, and reduction in the number of ICC count in proximal colon is involved in the mechanism.

关 键 词：吗啡 镇痛 硬膜外 结肠 间质细胞 

分 类 号：R614[医药卫生—麻醉学]