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肠道缺血:使用腔内全氟化合物降低死亡率

Intestinal ischemia: reduction of mortality utilizing intraluminal perfluorochemical.

作者信息

Ricci J L, Sloviter H A, Ziegler M M

出版信息

Am J Surg. 1985 Jan;149(1):84-90. doi: 10.1016/s0002-9610(85)80014-3.

Abstract

This study reports an assessment of a method of intestinal protection by the intraluminal administration of an oxygenated perfluorochemical, perfluorotributylamine, or gaseous oxygen in an attempt to provide oxygen for mucosal cells rendered ischemia. A model of acute arterial or acute arteriovenous ischemia was produced in adult female rats. All control ischemic animals died within 12 hours. To assess intestinal protection, the mortality rates in the experimental groups were compared with the 100 percent control mortality. Gaseous oxygen and oxygenated perfluorochemical administered intraluminally reduced mortality significantly in the acute arterial model but not in rats with arteriovenous occlusion. Electron microscopy demonstrated preservation of villi after 1 and 2 hours of occlusion in the oxygen-treated groups. Light microscopy revealed massive destruction in control animals with preserved architecture in both the gaseous oxygen and oxygenated perfluorochemical groups. These results demonstrate that the intraluminal delivery of oxygen to bowel rendered ischemic by arterial occlusion may significantly decrease anatomic bowel disruption and improve animal survival. Such techniques have a potential clinical application to facilitate salvage of ischemic intestine and to augment intestinal preservation.

摘要

本研究报告了一种肠保护方法的评估,该方法是通过腔内给予一种含氧全氟化合物、全氟三丁胺或气态氧,试图为处于缺血状态的黏膜细胞提供氧气。在成年雌性大鼠中建立了急性动脉或急性动静脉缺血模型。所有对照缺血动物均在12小时内死亡。为评估肠保护作用,将实验组的死亡率与100%的对照死亡率进行比较。腔内给予气态氧和含氧全氟化合物在急性动脉模型中显著降低了死亡率,但在动静脉闭塞的大鼠中则没有。电子显微镜显示,在氧处理组中,闭塞1小时和2小时后绒毛得以保存。光学显微镜显示,对照动物出现大量破坏,而气态氧组和含氧全氟化合物组的结构得以保存。这些结果表明,通过动脉闭塞导致缺血的肠腔内输送氧气可显著减少肠道解剖结构破坏并提高动物存活率。此类技术在促进缺血肠段的挽救及增强肠保存方面具有潜在的临床应用价值。

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