【作者】 董海聚；

【导师】 彭广能；

【作者基本信息】 四川农业大学 ， 临床兽医学， 2005， 硕士

【摘要】 本研究以犬为实验动物通过结扎小肠及相应肠系膜动静脉血管,制作绞窄性肠梗阻病理模型,实验设对照组、绞窄1组(缺血再灌注组,即直接解除肠管束扎)和绞窄2组(切除吻合组,即将绞窄肠管切除后进行肠管端端吻合),绞窄组又依解除梗阻的时间点不同分为2h、4h和6h组,以研究肠绞窄后及采用不同方法解除肠梗阻后血液、腹腔液和各实质器官内自由基变化的规律及其对机体的致病作用,为临床诊断和治疗肠梗阻奠定理论依据。 结果表明,随着肠绞窄时间的延长,血液中超氧化物歧化酶(SOD)值在1h时出现一过性升高,之后逐渐降低,腹腔液中SOD值直到梗阻2h才出现显著降低;血液中MDA浓度于梗阻1h即出现显著性升高,而腹腔液中丙二醛(MDA)浓度在梗阻2h才出现显著性升高,随后继续升高。绞窄1组各小组动物血液和腹腔液内SOD值和MDA浓度解除梗阻前后组内相比均差异极显著(p<0.01),绞窄2组各组动物解除梗阻前后SOD值和MDA浓度仅出现显著差异,且与绞窄1组对应组比较差异显著,但恢复较快。动物处死时(15h时),2h缺血再灌注组血液和腹腔液中SOD值和MDA浓度与对照组比较差异极显著,与2h肠管切除吻合组比较差异显著,2h肠管切除吻合组与对照组比较差异显著;而4h和6h缺血再灌注组动物存活均未超过15h。两绞窄组各小组组织内SOD含量均显著低于对照组,而MDA浓度显著高于对照组,绞窄2组各小组组织内SOD含量均显著高于绞窄1组对应值(p<0.05),MDA浓度显著低于后者(p<0.05)。病理学观察发现,梗阻2h肠管呈可复性损伤,梗阻6h肠管已完全坏死,梗阻4h肠管损伤介于可复与不可复之间;绞窄2组各小组组织器官病变均较绞窄1组对应组轻微。 结论:绞窄性肠梗阻发生后氧自由基确实对机体产生很大的损伤,表现为体内SOD的下降和MDA的升高;肠绞窄发生2h肠管损伤为可复性,预后良好,6h后肠管严重坏死,属完全不可复损伤,预后不良,梗阻4h后肠管的损伤介于可复与与不可复损伤之间,预后可疑;临床上一旦确诊为绞窄性肠梗阻病例立即进行绞窄肠管切除吻合,可明显减少氧自由基对机体的损伤。更多还原

【Abstract】 The study is to find the changes of free radical in the blood, peritoneal fluid, tissues and organs, and meanwhile to find the damage action of free radical to body in order to set up the base for the diagnosis and treatment of intestinal obstruction, by making the model of strangulated intestinal obstruction of canine. The experimental animals are divided into control group, obstructed group 1 ( ischemia reperfusion group-removing the bundle directly) and obstructed group 2 (cutting and inosculating group-cutting and inosculating strangulated intestine). The obstructed group is also divided into 2h, 4h and 6h group according to the time of removing the obstruction.The results show, with the prolongation of time after obstructed, the content of SOD in blood significantly steps up temporarily an hour later after obstructed and then degrade gradually, and in peritoneal fluid it is degrading significantly two hours later after obstructed; The density of MDA in blood increases significantly one hour later after obstructed, but in peritoneal fluid it appears to increase significantly two hours later after obstructed, and then continue to increase. After removing the obstruction, the density of the SOD and MDA of obstructed group 1 in blood and peritoneal fluid is sharply high (p<0. 01) , comparing with the ahead group of the obstruction, and the density of the SOD and MDA of obstructed group 2 appear significant changes, but the difference is significant comparing with the corresponding group of obstructed group 1, and the changes recovered very quickly. The content of SOD is degrading gradually with the prolongation of time after obstructed, but the content of MDA in blood and peritoneal fluid both step up significantly. When the animals was dead ( 15h) , the difference of the whole indexbetween the 2h ischemia reperfusion group and control group, between 2h groups is sharply significant (p<0. 01) , but between the 2h cutting and inosculating group and control group is significant (p<0.05) . But the animals of 4h and 6h ischemia reperfusion group don’t live beyond 15 hours. The content of SOD in tissues and organs of the two obstructed groups is little than it in the control group, but the content of MDA is higher than the control group. The content of SOD in tissues and organs of the cutting and inosculating group is higher significantly than the corresponding content of ischemia reperfusion group (p<0.05), but the concentration of MDA of the former is lower than the latter one. The intestinal damage is recoverable two hours later after obstructed, and the prognosis is well. The intestine is of severe necrosis six hours later after obstructed, and this damage is not recoverable and the prognosis is bad. The intestinal damage of obstructing 4 hours is between 2h and 6h after obstructed,, and the prognosis is questionable. The pathological change of all tissues and organs in the obstructed group 2 is little than the corresponding group of the obstructed group 1.Conclusion: The free radical actually does harm to the organism after strangulated intestinal obstruction, showing the degrading of SOD and increasing of MDA. The damage is recoverable 2 hours later after obstructed, and the prognosis is well. The intestine is of severe necrosis 6 hours later after obstructed, and this damage is not recoverable and the prognosis is bad. The intestinal damage of obstructing 4 hours is between 2h and 6h after obstructed, and the prognosis is questionable. Once the case of strangulated intestinal obstruction is made the final diagnosis,clinically, we should must cutting and inosculating the strangulated intestinal at once ,which can decrease the damage of oxygen free radical to body.更多还原