Tetikcok Ramazan, Kayaoglu Huseyin Ayhan, Ozsoy Zeki, Yenidogan Erdinc, Ozkan Namik, Celik Alper, Sahin Semsettin, Ersoy Omer Faik
Faculty of Medicine, Department of Family Medicine, Gaziosmanpasa University, Tokat, Turkey.
Faculty of Medicine, Department of General Surgery, Gaziosmanpasa University.
Wounds. 2016 Oct;28(10):354-359.
This study investigated and compared the effects of antibiotic and steroid lavage on survival and cytokine levels in an experimental abdominal sepsis model.
In abdominal sepsis, abdominal lavage with saline or antibiotic solutions is a well-documented intervention known to have positive impact on survival; however, the effects of steroid lavage in abdominal sepsis have not yet been investigated.
Ninety-six Wistar rats were divided into 4 groups (n = 24). Abdominal sepsis was induced by cecal ligation and puncture. Six hours after laparotomy, the authors performed a relaparatomy followed by cecal resection and an abdominal lavage. Abdominal lavage was performed using saline in group 1, equal volumes of cefazolin sodium in group 2, low-dose methylprednisolone (1 mg/kg) in group 3, and high-dose methylprednisolone (2 mg/kg) in group 4. After division of 2 subgroups from each of the 4 groups, the first of the rats (n = 12) were euthanized 6 hours later for evaluation of cytokines (ie, interleukin [IL] 1β, 2, 4, 10, and tumor necrosis factor alpha [TNF-α]), and the others were followed for 30 days for analysis of mortality rates.
The mortality rate of the rats in group 2 was significantly higher than group 4, which had no mortality (P = 0.032). Although insignificant, the lowest mean value of IL-1β, IL-2, and TNF-α were in group 1, and the highest was in group 2. The lowest IL-4 level was in group 3, and the highest level was in group 2 (P = 0.41). Interleukin-10 levels were significantly lower in group 4 and higher in group 2 (P = 0.014).
The authors state that peritoneal lavage with prednisolone improved survival rates with increasing doses in abdominal sepsis.
本研究调查并比较了抗生素灌洗和类固醇灌洗对实验性腹部脓毒症模型中生存率和细胞因子水平的影响。
在腹部脓毒症中，用生理盐水或抗生素溶液进行腹腔灌洗是一种有充分文献记载的干预措施，已知对生存率有积极影响；然而，类固醇灌洗在腹部脓毒症中的作用尚未得到研究。
将96只Wistar大鼠分为4组（每组n = 24）。通过盲肠结扎和穿刺诱导腹部脓毒症。剖腹术后6小时，作者再次剖腹，随后进行盲肠切除和腹腔灌洗。第1组用生理盐水进行腹腔灌洗，第2组用等量头孢唑林钠，第3组用低剂量甲基泼尼松龙（1 mg/kg），第4组用高剂量甲基泼尼松龙（2 mg/kg）。从4组中的每组再分出2个亚组后，每组的第一组大鼠（n = 12）在6小时后安乐死以评估细胞因子（即白细胞介素[IL] 1β、2、4、10和肿瘤坏死因子α [TNF-α]），其余大鼠随访30天以分析死亡率。
第2组大鼠的死亡率显著高于无死亡的第4组（P = 0.032）。虽然不显著，但IL-1β、IL-2和TNF-α的最低平均值在第1组，最高值在第2组。IL-4水平最低的是第3组，最高的是第2组（P = 0.41）。白细胞介素-10水平在第4组显著较低，在第2组较高（P = 0.014）。
作者指出，在腹部脓毒症中，用泼尼松龙进行腹腔灌洗可提高生存率，且生存率随剂量增加而提高。
