失血性休克及肠系膜上静脉阻断对兔小肠黏膜结构和屏障功能的影响(1)
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[摘要] 目的 本实验观察失血性休克、静脉阻断及开放后缺血-再灌注多重损伤对小肠黏膜结构和屏障功能的影响。方法 日本大白兔20只随机分为实验组和对照组，在各个时间段取肠系膜静脉血检测血浆内毒素及丙二醛水平，取末端回肠检测小肠黏膜厚度和绒毛高度。结果 实验组在休克1h后和再灌注1h后血浆内毒素及丙二醛水平均明显升高(P<0.01)；实验组小肠黏膜厚度和绒毛高度明显下降(P<0.01)。结论 在经历失血性休克、肠系膜上静脉阻断及再灌注损伤多重打击下，小肠黏膜结构和屏障功能遭受了严重破坏，进而引起细菌移位和内毒素血症，对机体造成不利影响。
[关键词] 失血性休克；再灌注损伤；肠系膜上静脉
[中图分类号] R574.5 [文献标识码] B [文章编号] 1673-9701(2011)23-16-02
The Change of Rabbit Intestinal Mucosa Structure and Barrier Function Endured Haemorrhagic Shock and Superior Mesenteric Vein Blocking
TAO Lijun1 FANG Jun1 WU Zuozhu1 CHEN Bicheng2
1.The No.1 Affiliated Hospital of Wenzhou Medical College，Wenzhou 325000，China；2. Experimental Animal Center，Wenzhou Medical College，Wenzhou 325000，China
[Abstract] Objective To study the change of rabbit intestinal mucosa structure and barrier function endured multiple damage by haemorrhagic shock，superior mesenteric vein blocking and ischemia reperfusion. Methods Twenty rabbits were divided randomly into two groups：normal control group and experimental group. Plasma endotoxin and MDA of superior mesenteric vein were detected before shock，one hour after shock and one hour following resuscitation，terminal ileum were taken to determinate ileum mucosa thickness and villus height. Results Plasma endotoxin and MDA levels of experimental group were elevated markedly(P<0.01)，ileum mucosa thickness and villus height were declined markedly compared with normal control group(P<0.01). Conclusion The intestinal mucosa structure and barrier function are heavily damaged by haemorrhagic shock，superior mesenteric vein blocking and ischemia reperfusion，then lead to bacteria translocation and endotoxemia，bring about organism harmful influence.
[Key words] Haemorrhagic shock；Ischemia reperfusion；Superior mesenteric vein
随着交通事故增多，临床上肠系膜撕裂伤致肠系膜上静脉破裂合并失血性休克病例日渐增多，手术中需阻断肠系膜上静脉进行修补，因此小肠黏膜需承受失血性休克低灌注、静脉阻断无血流及开放后缺血-再灌注三重损伤。本实验采用失血性休克动物模型模拟临床肠系膜上静脉破裂致失血性休克病例，观察失血性休克、静脉阻断及开放后缺血-再灌注多重损伤对小肠黏膜结构和屏障功能的影响。
1 材料与方法
1.1 造模与分组
日本大白兔20只，体重1.5～2.5kg，雌雄不限。术前禁食12h，自由饮水。戊巴比妥钠(3%，30mg/kg)耳缘静脉注射麻醉，分离左侧颈总动脉，插管接多功能监护仪监测动脉压；分离右侧颈外静脉用于输液及给药 ......
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