Woltmann A, Schult M, Schiedeck T, Markert U, Bruch H P
Klinik für Chirurgie, Medizinische Universität zu Lübeck.
Zentralbl Chir. 1999;124(3):195-8.
The peritoneal lavage in peritonitis can be studied in a standardized manner only in animal models, because peritonitis is too variable and dependent on too many patient related factors. In this article answers are given to questions on the influence of different lavage substances on survival, local and systemic concentrations of bacteria, endotoxin, and TNF as well as on mesothelial adherence of bacteria. These data refer to results from acute models of infection published in the literature. Furthermore, we show from our own chronic peritonitis model the influence of the peritoneal lavage on abscess formation and translocation. After inoculation of a Bacteroides fragilis suspension, a chronic abscess forming peritonitis was induced. At day 3/7/14 intraabdominal abscesses were found in 2/4/6 of 8/5/6 animals in an untreated, in 1/3/5 of 5/5/5 animals in a saline lavaged, and in 5/0/2 of 5/5/5 animals in a Taurolidin lavaged group, respectively. Both, the intraabdominal and the systemic bacterial dissemination were more effectively inhibited by the Taurolidin lavage than by the saline lavage.
由于腹膜炎情况过于多变且取决于太多与患者相关的因素，因此只有在动物模型中才能以标准化方式研究腹膜炎的腹腔灌洗。本文针对不同灌洗物质对生存率、细菌、内毒素和肿瘤坏死因子（TNF）的局部及全身浓度以及细菌与间皮黏附的影响等问题给出了答案。这些数据参考了文献中发表的急性感染模型的结果。此外，我们从自己的慢性腹膜炎模型中展示了腹腔灌洗对脓肿形成和细菌移位的影响。接种脆弱拟杆菌悬液后，诱发了形成慢性脓肿的腹膜炎。在第3/7/14天，未治疗组8/5/6只动物中有2/4/6只出现腹腔内脓肿，生理盐水灌洗组5/5/5只动物中有1/3/5只出现，替考拉宁灌洗组5/5/5只动物中有5/0/2只出现。替考拉宁灌洗比生理盐水灌洗更有效地抑制了腹腔内和全身的细菌播散。
