Song Hua-Li, Zhang Dong-Mei, Wen Heng, Wang Meng, Zhao Na, Gao Yu-Hua, Ding Ni
Department of Anesthesiology, Ningxia Medical University, Yinchuan, Ningxia, China.
Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
J Surg Res. 2018 Aug;228:93-99. doi: 10.1016/j.jss.2018.02.055. Epub 2018 Apr 25.
Although peritoneal lavage with povidone-iodine (PVPI) is frequently performed after surgery on the gastrointestinal tract, the effects of PVPI on the intestinal epithelial barrier are unknown. The purpose of this study was to investigate the effects of abdominal irrigation with PVPI on the intestinal epithelial barrier in a colorectal cancer (CRC)-induced rat model.
The CRC model was induced in rats with azoxymethane and dextran sodium sulfate. Next, a total of 24 male CRC-induced rats were randomly divided into three groups (n = 8): (1) a sham-operated group, (2) an NS group (peritoneal lavage 0.9% NaCl), and (3) a PVPI group (peritoneal lavage with 0.45%-0.55% PVPI). The mean arterial pressure was continuously monitored throughout the experiment. The levels of plasma endotoxin and D-lactate, blood gases, and protein concentration were measured. The ultrastructural changes of the epithelial tight junctions were observed by transmission electron microscopy.
The mean arterial pressure after peritoneal lavage was lower in the PVPI group than that in the NS group. The protein concentration and levels of endotoxin and D-lactate were higher in the PVPI group than they were in the PVPI group. In addition, PVPI treatment resulted in a markedly severe metabolic acidosis and intestinal mucosal injury compared with NS rats.
Peritoneal lavage with PVPI dramatically compromises the integrity of the intestinal mucosa barrier and causes endotoxin shock in CRC rats. It is unsafe for clinical applications to include peritoneal lavage with PVPI in colorectal operations.
尽管胃肠道手术后常采用聚维酮碘（PVPI）进行腹腔灌洗，但PVPI对肠上皮屏障的影响尚不清楚。本研究旨在探讨在结直肠癌（CRC）诱导的大鼠模型中，PVPI腹腔灌洗对肠上皮屏障的影响。
用氧化偶氮甲烷和葡聚糖硫酸钠诱导大鼠建立CRC模型。接下来，将总共24只雄性CRC诱导大鼠随机分为三组（n = 8）：（1）假手术组，（2）生理盐水组（用0.9%氯化钠进行腹腔灌洗），（3）PVPI组（用0.45%-0.55% PVPI进行腹腔灌洗）。在整个实验过程中持续监测平均动脉压。测量血浆内毒素和D-乳酸水平、血气和蛋白质浓度。通过透射电子显微镜观察上皮紧密连接的超微结构变化。
PVPI组腹腔灌洗后的平均动脉压低于生理盐水组。PVPI组的蛋白质浓度、内毒素和D-乳酸水平高于生理盐水组。此外，与生理盐水组大鼠相比，PVPI处理导致明显更严重的代谢性酸中毒和肠黏膜损伤。
PVPI腹腔灌洗显著损害CRC大鼠肠黏膜屏障的完整性并导致内毒素休克。在结直肠手术中采用PVPI腹腔灌洗用于临床应用是不安全的。
