Falk A, Redfors S, Myrvold H, Haglund U
Circ Shock. 1985;17(4):327-37.
The pathogenesis of small intestinal mucosal damage in septic shock was explored in experiments on 15 cats given live E coli i.v. Villous (absorptive site) blood flow was studied by the carbon monoxide uptake technique using isolated small intestinal segments. In eight of the cats, segments were perfused intraluminally with oxygenated or nitrogenated saline. The main part of the small intestine was unperfused and served as control. Nine cats (60%) developed mucosal damage. They had significantly lower arterial blood pressure at the end of septicemia (56 +/- 6) than cats without mucosal damage (76 +/- 3 mmHg). Total intestinal blood flow was similar before or during septicemia. Villous blood flow before septicemia was 3.7 +/- 0.5 ml/min X 100 g intestine and 5.1 +/- 1.0 (n.s.) in the two groups, respectively, and remained unchanged. Intraluminal perfusion with oxygenated but not with nitrogenated saline prevented the development of mucosal damage. It was concluded that the small intestinal mucosal damage is due to hypoxia in spite of unchanged villous blood supply.
通过对15只静脉注射活大肠杆菌的猫进行实验,探讨了感染性休克中小肠黏膜损伤的发病机制。使用离体小肠段,通过一氧化碳摄取技术研究绒毛(吸收部位)血流。8只猫的肠段腔内灌注含氧或含氮盐水。小肠的主要部分未灌注,作为对照。9只猫(60%)发生了黏膜损伤。它们在败血症末期的动脉血压(56±6)明显低于未发生黏膜损伤的猫(76±3 mmHg)。败血症之前或期间的总肠血流量相似。败血症之前两组的绒毛血流分别为3.7±0.5 ml/min×100 g肠和5.1±1.0(无显著差异),且保持不变。腔内灌注含氧盐水而非含氮盐水可防止黏膜损伤的发生。得出的结论是,尽管绒毛血液供应未变,但小肠黏膜损伤是由于缺氧所致。