Wang X D, Soltesz V, Andersson R, Bengmark S
Department of Surgery, Lund University, Sweden.
Br J Surg. 1993 Jan;80(1):66-71. doi: 10.1002/bjs.1800800124.
Bacterial infection and bacteraemia have been observed in patients with acute liver failure. The exact source of bacteria and nature of pathophysiological mechanisms explaining the development of infection remain unclear. In the present study, acute liver failure was induced by 90 per cent hepatectomy in the rat. The mesenteric lymph nodes and organs were harvested aseptically for bacteriological culture after sham operation or 90 per cent hepatectomy. Function of the liver and reticuloendothelial system (RES) was assayed; gut oxygen extraction was also measured. Translocation of enteric bacteria occurred 2 h after operation and increased with time following hepatectomy. Overgrowth of Escherichia coli in the distal small intestine started 2 h after operation. RES function decreased immediately after 90 per cent hepatectomy; uptake rates per gram tissue in other organs increased significantly. These results indicate that bacterial translocation occurred early after 90 per cent hepatectomy, associated with a decrease in RES function and gut oxygen extraction, and overgrowth of intestinal bacteria.
在急性肝衰竭患者中已观察到细菌感染和菌血症。细菌的确切来源以及解释感染发生的病理生理机制的本质仍不清楚。在本研究中,通过大鼠90%肝切除术诱导急性肝衰竭。在假手术或90%肝切除术后,无菌采集肠系膜淋巴结和器官进行细菌培养。测定肝脏和网状内皮系统(RES)的功能;还测量肠道氧摄取。肠道细菌移位在术后2小时发生,并在肝切除术后随时间增加。术后2小时远端小肠中的大肠杆菌开始过度生长。90%肝切除术后RES功能立即下降;其他器官每克组织的摄取率显著增加。这些结果表明,90%肝切除术后早期发生细菌移位,与RES功能和肠道氧摄取减少以及肠道细菌过度生长有关。