机械性肠梗阻时限和血运与细菌移位关系的动物实验研究

研究机械性肠梗阻时限和血运对细菌移位的影响，并探讨其机制。４０只ＳＤ鼠分为５组：①对照组；②６、２４、４８小时单纯性完全性机械性肠梗阻组；③３小时闭袢性绞窄性肠梗阻组。无菌操作取血和肠系膜淋巴结、肝、脾、肠内容物的匀浆培养，鉴定、计数细菌；测定血浆内毒素，光镜检查肠粘膜结构。总细菌移位率在单纯性肠梗阻２４、４８小时及绞窄性肠梗阻３小时分别为４６．８％、５９．４％和５３．１％，较对照组３．１％及单纯性肠梗阻６小时的１２．５％均有极显著性差异（Ｐ＜０．０１）。单纯性机械性肠梗阻随梗阻时间延长，细菌移位发生率升高，肠绞窄短时间即可造成严重细菌移位。细菌移位机制包括肠道内细菌过度生长，肠粘膜屏障破坏。

Animal Study on Bacterial Translocation Caused by Mechanical Intestinal Obstruction:theImportance of Time and Ischemia of Intestinal Obstruction

To investigate the effects of time and ischemia of obstruction on bacterialtranslocation and their mechanisms. Forty Sprague-Dawley rats were divided into 5 groups:1.Sham-ligated group,2. 6h,24h and 48h simple intestinal obstruction group,3.3h strangulatedobstruction group.The mesenteric lymph nodes,spleen,and liver were excised,segments ofileum were removed aseptically,the dilutions of homogenate were cultured to identificate thebacteria and to determinate its population levels. The plasma endotoxin was detected. The ileummucosal structure was analyzed by light microscopy. Bacterial translocation rate in 24 hours,48hours simple intestinal obstruction and 3 hours strangulated obstruction group were 46.8%,59.4%,and 53.1%respectively. Each was highet than that of sham-ligated group(3.1%)or 6hours simple intestinal obstruction group(12.5%).(P< 0.01 ).The longer the intestine wereobstructed,the higher the incidence of bacterial translocation induced.A short period of ischemiacan make more severe bacterial translocation. The overgrowth of the indigenous bacteria, physicaldisruption of the gut mucosal barrier promote bacterial translocation from the gut.