【作者】 王力利； 李勇； 田利飞； 范立侨； 赵群； 刘羽； 李兆星； 安昭杰；

【Author】 WANG Li-li;LI Yong;TIAN Li-fei;FAN Li-qiao;ZHAO Qun;LIU Yu;LI Zhao-xing;AN Zhao-jie;Department of General Surgery,the Fourth Affiliated Hospital,Hebei Medical University;

【机构】 河北医科大学第四医院外三科；

【摘要】 目的:探讨胸导管引流对急性重症胰腺炎(Severe Acute Pancreatitis,SAP)伴肠屏障功能障碍(Intestine barrier functional disturbance,IBFD)大鼠保护作用及其作用机制,为临床治疗提供新的思路和实验依据。方法:大鼠随机分为假手术组(J组)、颈部胸导管引流对照组(Sham组)、SAP组(S组)、SAP颈部胸导管引流干预组(L组),每组又分为2、6、12h 3个时段。应用显微外科技术制作颈部胸导管引流模型,通过逆行胰胆管注射5%牛磺胆酸钠(0.11ml/100g体重),诱导SAP模型,观察腹水及淋巴液性状、胰腺和肠病理形态变化,检测血清/淋巴液/腹水中淀粉酶(amylase,AMY)水平变化、血浆/淋巴液中内毒素(endotoxin)浓度变化、血清/淋巴液/肠及胰腺组织匀浆中过氧化氢酶(catalase,CAT)活力和谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-PX)活力变化。结果:与同时点SAP组比较:L组各时点腹水量明显减少(P<0.01),颜色变浅;显著改善胰腺及小肠的病理损伤;血清、腹水淀粉酶明显降低(P<0.01);血浆内毒素明显降低(P<0.05);血清、肠及胰腺组织匀浆中CAT、GSH-PX明显升高(P<0.05 or P<0.01)。结论:颈部胸导管引流可减轻SAP合并肠屏障损伤。更多还原

【Abstract】 Objectives:Investigate protective effect and mechanism of the Cervical thoracic duct drainage on Severe Acute Pancreatitis(SAP) with Intestine barrier functional disturbance(EBFD) rats,provide new ideas and experimental basis being used to guide clinical treatment of intestinal barrier dysfunction with SAP.Methods:SD healthy male rats were randomly divided into 4 groups:sham operation group(J),the control group of Cervical thoracic duct drainage(Sham),SAP group(S),Cervical thoracic duct drainage + SAP group(L).Each group then randomly divided into 2h group,6h group and 12h group.Used Microsurgical technique to make model of Cervical thoracic duct drainage,SAP model were made by retrograde injection of 5%sodium taurocholate into the biliopancreatic duct(0.11ml/100g weight).Tested the trait of ascites and lymph,the path-morphologic change of pancreas and intestines,the amylase(AMS) level of ascites,lymph and serum,the level of Endotoxin in lymph and plasma,detect the activity of catalase(CAT) and glutathione-peroxidase(GSH-PX) level in lymph,serum,pancreas and distal ileum tissue.Results:Compared with SAP group at the corresponding time point:L group had less ascites with light-colored(P<0.01).The pathological changes of pancreas and intestine got lower scores.The AMS level of ascites and serum,the level of Endotoxin in plasma were decreased significantly(P<0.01 or P<0.05).While the activity of catalase(CAT) and glutathione-peroxidase(GSH-PX)level in serum,pancreas and distal ileum tissue were increased obviously(P<0.05 or P<0.01).Conclusions:Cervical thoracic duct drainage alleviate the injury caused by SAP with IBFD.更多还原