摘要
目的 评价肠静脉回流阻断肠淤血时肠屏障的变化。方法 采用种群相近的猪8只,无感染症状。分离门静脉和肝后下腔静脉分别阻断、然后开放各50 min,分别观察动脉血压、心率、血气分析、手术中肠颜色及形态变化。在各时间点取回肠末端小肠全层,行光镜及电镜检查,测定肠丙二醛(MDA)含量及门、颈静脉血内毒素含量。结果 8只猪一般情况无差别。阻断后,肠淤血、水肿,并随时间延长而加重。光镜下阻断前基本正常,实验结束时绒毛、腺体均有损伤。电镜下阻断前细胞形态基本正常,阻断后细胞超微结构轻微异常。阻断前后的肠MDA含量、血内毒素含量无显著性差异。结论肠静脉回流阻断引起的肠道淤血可导致肠粘膜屏障损伤。在50 min内肠淤血性的损伤不会xh起肠腔内内毒索的大量移位。
Objective To investigate the changes in intestinal barrier function induced by intestinal venous congestion produced by portal vein clamping.Methods Eight healthy pigs (6 months old) weighing about 25 kg were used in this study. Anesthesia was induced with intramuscular ketamine 300 mg·kg-1 and scopolamine 0.3 mg and maintained with ketamine infusion supplemented with intermittent iv boluses of fentanyl, midazolam and vecuronium. The animals were tracheotomized and mechanically ventilated. Right external jugular vein was cannulated for CVP monitoring, fluid infusion and blood sampling. Carotid artery was cannulated for continuous direct BP monitoring and blood sampling. Abdomen was opened. Portal vein and retrohepatic vena cava were cross-clamped for 50 min and then released, 50 min later the animals were sacrificed. BP, HR and CVP were monitored during the surgery. Arterial blood samples were taken before, 50 min after cross-clamping and 50 min after unclamping for blood gas analysis. Blood samples were taken from portal vein and jugular vein before, 30 min and 50 min after cross-clamping and 15 min,50 min after unclamping for determination of plasma endotoxin level. A small segment of distal ileum was removed before, 50 min after cross-clamping and 50 min after declamping for determination of intestinal malondialdehyde (MDA) content, and microscopic (light and electronic) examination. Results After portal vein clamping the gut turned dark blue and became edematous. Light microscopic examination showed significant injury to intestinal villi and glands 50 min after unclamping. Electron microscopic examination showed mild ultrastructural changes which were not uniformly distributed. There were no significant differences in intestinal tissue MDA level and plasma endotoxin level before and after portal vein cross-clamping. Conclusion Intestinal venous congestion induced by portal vein and retrohepatic vena cava cross-clamping can cause injury to gut barrier in healthy pigs, and intestinal congestion lasting less th
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2003年第5期351-354,共4页
Chinese Journal of Anesthesiology
基金
国家自然科学基金资助(30070733)
广东省卫生厅基金资助(A2000156)
广东省卫生厅基金资助(2001143)
关键词
肠淤血
肠静脉回流阻断
肠道损伤
内毒素
感染
Intestine,small
Ischemia
Reperfusion injury
Bacterial translocation
Permeability
