聚维酮碘腹腔灌洗对腹腔海水浸泡伤大鼠术后败血症的防治作用  

Effect of peritoneal lavage with povine-iodine on prevention of postoperative sepsis after exposure of peritoneal cavity to sea water in rat

作　　者：王志伟[1] 金浩生[1] 罗真东[1] 谢尚奎[1] 胡世雄[1] 刘献棠[1] 吴印爱[1] 

机构地区：[1]解放军第一五七医院普通外科,广州510510

出　　处：《中国危重病急救医学》2004年第2期103-105,共3页Chinese Critical Care Medicine

基　　金：广州军区重点科研课题资助项目 (2 0 0 1A14 );广东省医学科研基金立项课题 (A2 0 0 15 17)

摘　　要：目的　观察聚维酮碘腹腔灌洗对防治腹腔海水浸泡伤后败血症的作用。方法　建立大鼠腹腔开放伤动物模型。选取 SD大鼠 84只 ,随机均分为腹腔海水浸泡组 (A组 ,4 2只 )及聚维酮碘灌洗组 (B组 ,4 2只 ) ,观察每个时间点 6只动物处理前后血浆内毒素 (ET)和肿瘤坏死因子 (TNF)的变化及每组 18只大鼠腹腔灌洗后 2 4 h血细菌培养阳性率。结果　 1腹腔海水浸泡后 A、B组 ET及 TNF水平均显著升高 (与浸泡前比较 ,P均 <0 .0 5 ) ;自术后 12 h开始 ,B组血浆 ET及 TNF水平均显著低于 A组 (P<0 .0 5或 P<0 .0 1)。2术后 2 4 h,B组细菌培养总阳性率为 16 .7% (3/ 18) ,显著低于 A组 77.8% (14 / 18,P<0 .0 1)。结论　聚维酮碘灌洗腹腔可显著降低血浆 ET及 TNF水平 ,降低血细菌培养阳性率 ,减少机体败血症发生的可能性。Objective To observe the effects of pe ritoneal lavage with povine-iodine on prevention of sepsis after expo sure of peritoneal cavity to sea water in rat . Methods Eighty-four SD rats were randomly divided into two groups, and the pe ritoneal cavity was exposed to sea water. Rats in group A were not treated (grou p A, n=42), and the peritoneal cavity was lavage with povine-iodi ne in group B(n=42). Plasma levels of endotoxin and tumor necrosis factor(TNF) were measured preimmersion, and 0, 12, 24 hours after s eawater immersion(n=6), and positive incidence of blood bacterial culture was performed(n=18 in each group) in groups A and B. Results ① Plasma levels of endotoxin and TNF in group A and B were increased significantly after exposure of peritoneal cavity to sea water (compared with baseline values, all P<0.05). Plasma levels of endotoxin and TNF in group B became lower than those in group A from 12 hours after seawater immersion( P<0.05 or P<0.01). ② Positive incidence of bacterial culture in group B was 16.7 % (3/18) and it was lower than that in group A 〔77.8 % (14/18), P<0.01〕. Conclusion Povine-iodine lavage in the peritoneal cavity can reduce levels o f plasma endotoxin and TNF, and lower positive incidence of bacterial culture in rats after exposure of peritoneal cavity to sea water, thereby preventing the development of postoperative sepremia.

关 键 词：海水浸泡伤 聚维酮碘 内毒素 肿瘤坏死因子 

分 类 号：R82[医药卫生—临床医学]