Juel I S, Solligård E, Skogvoll E, Aadahl P, Grønbech J E
Department of Surgery, St. Olav University Hospital, Trondheim, Norway.
Eur Surg Res. 2007;39(6):340-9. doi: 10.1159/000105132. Epub 2007 Jul 6.
The present study evaluates whether microdialysis of glycerol and lactate reflects mucosal injury and permeability changes after strangulation obstruction of the pig small intestine.
Strangulation obstruction was induced by tightening a rubber band around a small bowel loop until its venous pressure increased to a level just below diastolic aortic pressure (partial strangulation), or further until cessation of flow in the main feeding artery (total strangulation). Mucosal injury and permeability of marker molecules from blood to lumen and vice versa was compared to release of glycerol and lactate to the intestinal lumen.
Mucosal injury, hyperpermeability, and release of glycerol were more pronounced after total than after partial strangulation. In animals with partial strangulation there was a complete restitution of the surface epithelium, and luminal glycerol and lumen-to-blood permeability of polyethylene glycol 4000 remained low. Such animals showed a sustained elevation of lactate and blood-to-lumen permeability of fluorescein isothiocyanate dextran after 2 h of partial strangulation, but a decline to baseline levels of these parameters in animals with 1 h partial strangulation.
Microdialysis of lactate and glycerol in the intestinal lumen may be used to assess structural and functional changes of the intestinal mucosa after strangulation obstruction.
本研究评估甘油和乳酸的微透析是否能反映猪小肠绞窄性梗阻后的黏膜损伤和通透性变化。
通过在小肠肠袢周围收紧橡皮筋诱导绞窄性梗阻,直至其静脉压升高至略低于舒张期主动脉压的水平(部分绞窄),或进一步直至主要供血动脉血流停止(完全绞窄)。将黏膜损伤以及标记分子从血液到肠腔及反之的通透性与甘油和乳酸向肠腔的释放情况进行比较。
完全绞窄后黏膜损伤、高通透性及甘油释放比部分绞窄后更明显。在部分绞窄的动物中,表面上皮完全恢复,肠腔内甘油及聚乙二醇4000从肠腔到血液的通透性仍较低。此类动物在部分绞窄2小时后乳酸持续升高,异硫氰酸荧光素葡聚糖从血液到肠腔的通透性也持续升高,但在部分绞窄1小时的动物中这些参数降至基线水平。
肠腔内乳酸和甘油的微透析可用于评估绞窄性梗阻后肠黏膜的结构和功能变化。