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脾切除术对革兰氏阴性菌血症的影响。

The effect of splenectomy on gram-negative bacteremia.

作者信息

Scher K S, Wroczynski F, Coil J A

出版信息

J Trauma. 1982 May;22(5):407-9. doi: 10.1097/00005373-198205000-00010.

Abstract

Both clinical and laboratory studies have demonstrated an increased risk of fatal sepsis after splenectomy. The importance of the spleen in clearing a bacterial challenge from pneumococci or other encapsulated organisms is now well accepted. The role of the spleen in handling a bacteremia due to nonencapsulated (Gram negative) organisms is not well established. Rats were subjected to either sham operation or splenectomy. Two weeks after surgery, all animals received 10(6) E. coli by intraperitoneal injection. Tail vein blood samples for quantitative culture were obtained at multiple time intervals after the bacterial challenge. All animals developed a bacteremia. Initially, the mean bloodstream bacterial counts were comparable in the sham and splenectomy groups. Sham-operated rats cleared all bacteria from the bloodstream within 240 minutes. In contrast, 240 minutes after bacterial injection, E. coli could still be recovered from the blood of asplenic rats at levels comparable to those noted at the start of the experiment. The present study shows that splenectomy does impair the animal's ability to clear a Gram-negative bacteremia.

摘要

临床研究和实验室研究均表明,脾切除术后发生致命性败血症的风险增加。脾脏在清除肺炎球菌或其他包膜菌的细菌攻击中的重要性现已得到广泛认可。脾脏在处理由非包膜(革兰氏阴性)菌引起的菌血症中的作用尚未明确。将大鼠分为假手术组或脾切除组。术后两周,所有动物腹腔注射10(6) 大肠杆菌。在细菌攻击后的多个时间间隔采集尾静脉血样进行定量培养。所有动物均发生菌血症。最初,假手术组和脾切除组的平均血流细菌计数相当。假手术大鼠在240分钟内清除了血液中的所有细菌。相比之下,细菌注射后240分钟,仍可从无脾大鼠的血液中检测到大肠杆菌,其水平与实验开始时相当。本研究表明,脾切除确实会损害动物清除革兰氏阴性菌血症的能力。

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