Nayci Ali, Atis Sibel, Ersoz Gulden, Polat Ayse
Department of Pediatric Surgery, Mersin University School of Medicine, Mersin, Turkey.
Respiration. 2004 Jan-Feb;71(1):66-71. doi: 10.1159/000075651.
Selective gut decontamination is suggested to suppress the gram-negative bacterial overgrowth in the intestine and consequently to reduce bacterial translocation.
The purpose of the present study is to examine the effects of gut decontamination on bronchoscopy-induced bacterial translocation, and intestinal mucosal injury.
Forty-five rats were assigned into three groups. Group 1 served as control (n=15). Group 2 (n=15) and group 3 (n=15) underwent bronchoscopy. In addition, group 3 underwent gut decontamination. Gut decontamination was performed two days prior to bronchoscopy with erythromycin and neomycin. Twenty-four hours after bronchoscopy, blood, mesenteric lymph nodes, spleen, liver, ileum and cecum were harvested for bacterial determination. The ileum was also assessed and graded histologically according to Chiu's injury scale.
In the bronchoscopy group, bacterial translocation to the mesenteric lymph nodes was found in 7/15 rats (46.7%), compared to none of the controls (p=0.01). These rats also showed significant evidence of intestinal injury, compared to the controls (mean ranks, 32.7 or 8.5, p<0.0001). On the other hand, gut decontamination prevented bacterial translocation, compared to the bronchoscopy group (p=0.011). However, gut decontamination provided no beneficial effect on the intestinal mucosal injury, compared to the bronchoscopy group. These animals also revealed significant intestinal injury, compared to the controls (mean ranks, 27.8 or 8.5, p<0.0001).
Our data shows that despite no amelioration in bronchoscopy-induced intestinal mucosal injury, gut decontamination has a preventive role for bronchoscopy-induced bacterial translocation.
选择性肠道去污被认为可抑制肠道内革兰氏阴性菌过度生长，从而减少细菌移位。
本研究旨在探讨肠道去污对支气管镜检查引起的细菌移位及肠黏膜损伤的影响。
45只大鼠分为三组。第1组为对照组（n = 15）。第2组（n = 15）和第3组（n = 15）接受支气管镜检查。此外，第3组进行肠道去污。在支气管镜检查前两天用红霉素和新霉素进行肠道去污。支气管镜检查后24小时，采集血液、肠系膜淋巴结、脾脏、肝脏、回肠和盲肠进行细菌检测。还根据Chiu损伤量表对回肠进行组织学评估和分级。
在支气管镜检查组中，15只大鼠中有7只（46.7%）出现细菌移位至肠系膜淋巴结，而对照组无一例出现（p = 0.01）。与对照组相比，这些大鼠还显示出明显的肠损伤证据（平均秩次，32.7或8.5，p < 0.0001）。另一方面，与支气管镜检查组相比，肠道去污可预防细菌移位（p = 0.011）。然而，与支气管镜检查组相比，肠道去污对肠黏膜损伤没有有益作用。与对照组相比，这些动物也显示出明显的肠损伤（平均秩次，27.8或8.5，p < 0.0001）。
我们的数据表明，尽管肠道去污不能改善支气管镜检查引起的肠黏膜损伤，但对支气管镜检查引起的细菌移位有预防作用。
