摘要
目的 观察不同方法对急性坏死性胰腺炎 (ANP)并发感染的防治效果。方法 将 86只大鼠随机分为 4组 :对照组 (n =2 0 )、ANP组 (n =2 2 )、乳果糖组 (n =2 2 )及导泻加抗生素组 (n =2 2 )。于光镜下观察肠粘膜损伤情况 ,并用镧作示踪剂观察肠粘膜通透性和肠粘膜细胞的渗透性 ;另切取胰腺组织、肠系膜淋巴结和抽取腹水作细菌培养。结果 ANP组、乳果糖组和导泻加抗生素组细菌移位与对照组比较差异有统计学意义 (P<0 .0 5 ) ,且前 3组组间细菌移位差异亦有统计学意义 (P<0 .0 5 ) ,乳果糖组和导泻加抗生素组能明显改善肠道屏障的病理变化 ,在光镜下ANP组、乳果糖组及导泻加抗生素组之间肠粘膜损伤程度比较差异有统计学意义 (P<0 .0 1)。结论 乳果糖和导泻加抗菌治疗能减少细菌移位 ,保护肠粘膜 ,是防治ANP并发感染的有效措施。
Objective The changes of intestinal permeability and relationship of intestinal mucosa and bacterial translocation were studied in rat acute necrotizing pancreatitis (ANP) models.Methods The ANP models were made by injection of 5% sodium taurocholate 1.0 ml into pancreatic subcapsula.Then wistar rats were divided into four groups,control group ( n =20),ANP group( n =22),treatment model group fed with lactose ( n =22) and treatment model group fed with MgSO 4 and antibiotic ( n =22).After 72 hours,the experimental models were sacrificed.Tissues of pancreas,mesenteric lymph node, ascites were collected for microbiological study.The intestinal permeability was observed by lanthanum tracer.The blood samples were obtained from portal vein and ascites in order to assay the amount of amylase in serum.The pathologic lesions were found in the intestinal villus of the model group, including acute necrosis of intestinal mucosa,necrotic haemorrhage as well as enteroparalysis and a mass of haemorrhagic ascites.Results Bacterial translocation of model group were markedly elevated than that of control ( P <0.05).There were statistically significant differences in bacterial translocation among three model groups ( P <0.05).The pathologic lesions were found in the intestinal villus of the model group,including acute necrosis of intestinal mucosa,necrotic haemorrhage as well as enteroparalysis and a mass of haemorrhagic ascites.The lanthanum grain in clearance of intestinal cell of model group can be observed by eletron microscope.Conclusion There is a severe gut barrier damage and injury in the intestinal mucosa,which lead to bacterial translocation from intestine as the source of pancreatic infection.Cleaning out enteric bacteria,improving intestinal movement and feeding with lactose could decrease bacterial translocation to treat and prevent acute necrotizing pancreatitis.
出处
《中国普外基础与临床杂志》
CAS
2002年第6期380-383,共4页
Chinese Journal of Bases and Clinics In General Surgery
