Mueller G L, Burney R E, MacKenzie J R
Ann Emerg Med. 1982 Jul;11(7):343-7. doi: 10.1016/s0196-0644(82)80358-2.
Elevation of the corrected leukocyte count (Cwbc) in peritoneal lavage effluent has been reported by us in association with colon perforation. We have extended this study in order to investigate systematically the nature of the stimuli to, and the timing, magnitude, and consistency of this response in the presence of other occult abdominal injuries associated with trauma. This has been done by subjecting an anesthetized canine model to a variety of isolated intra-abdominal injuries and then measuring sequential peritoneal lavage leukocyte counts up to six hours after injury. A rising lavage leukocyte count gave Cwbc-positive lavages in 94% of animals with jejunal, ileal, and colonic wounds by six hours. In animals with isolated peritoneal penetration alone, or simple liver or spleen wounds, an elevated Cwbc count was unusual. In stomach, gallbladder, and urinary bladder perforation, a positive lavage was an inconsistent finding. Peritoneal lavage leukocyte counts corrected on the basis of red cell count can enhance the accuracy and utility of lavage for abdominal trauma, especially when gastrointestinal perforation is present as an isolated injury, by detecting an early peritoneal inflammatory response which appears independently from simple hemorrhage. [Mueller GL, Burney RE, MacKenzie JR: Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.
我们曾报道过，结肠穿孔时腹腔灌洗流出液中校正白细胞计数（Cwbc）会升高。我们扩展了这项研究，以便系统地调查在存在与创伤相关的其他隐匿性腹部损伤时，引发这种反应的刺激因素的性质，以及该反应的时间、程度和一致性。这是通过对麻醉的犬模型施加各种孤立的腹部损伤，然后在损伤后长达6小时内连续测量腹腔灌洗白细胞计数来完成的。到6小时时，在94%有空肠、回肠和结肠伤口的动物中，灌洗白细胞计数升高导致Cwbc灌洗呈阳性。仅存在孤立的腹膜穿透或单纯肝脏或脾脏伤口的动物中，Cwbc计数升高并不常见。在胃、胆囊和膀胱穿孔时，灌洗呈阳性的结果并不一致。基于红细胞计数校正的腹腔灌洗白细胞计数可以提高腹腔灌洗对腹部创伤的准确性和实用性，尤其是当胃肠道穿孔作为孤立损伤存在时，通过检测独立于单纯出血出现的早期腹膜炎症反应来实现。[穆勒GL，伯尼RE，麦肯齐JR：实验模型中选定腹部器官损伤后腹腔灌洗流出液中的白细胞增多。
