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橡胶引流片腹腔植入后肠道细菌移位

Enteric bacterial translocation after intraperitoneal implantation of rubber drain pieces.

作者信息

Guo W, Andersson R, Ljungh A, Wang X D, Bengmark S

机构信息

Dept. of Surgery, Lund University, Sweden.

出版信息

Scand J Gastroenterol. 1993 May;28(5):393-400. doi: 10.3109/00365529309098238.

Abstract

To study the kinetics and mechanisms of bacterial translocation from the gut after intraperitoneal (IP) implantation of prosthetic materials, different sizes of rubber drain pieces were intraperitoneally implanted in the rat, followed by evaluation of ileal mucosal permeability after 2 days and of the occurrence of bacterial translocation and gut oxygen extraction at various time points. Enteric bacteria translocated to mesenteric lymph nodes and disseminated to systemic organs (liver, spleen, lungs, and kidneys), the portal vein, and inferior vena cava 2, 4, and 6 h after IP implantation of rubber drain pieces with 10-, 7-, and 3-cm2 areas, respectively, and subsequently to the IP rubber drain piece and the peritoneal cavity on the 2nd postoperative day. The incidence of translocation correlated with the size of the implanted material and time after implantation. The gut oxygen extraction increased significantly after IP implantation of 7- and 10-cm2 rubber drain pieces. The ileal mucosal permeability was enhanced in the groups implanted with 7- and 10-cm2 drain pieces. Thus, bacterial translocation occurs already in the early period after IP implantation of rubber drain and increased with time. The increased gut oxygen extraction implies that the gut is susceptible to IP inflammatory stimulation, and the enhanced ileal permeability suggests that the integrity of the gastrointestinal tract is compromised, which might facilitate bacterial translocation.

摘要

为研究腹腔内(IP)植入假体材料后肠道细菌移位的动力学及机制,将不同尺寸的橡胶引流片腹腔内植入大鼠体内,2天后评估回肠黏膜通透性,并在不同时间点评估细菌移位的发生情况及肠道氧摄取。分别在植入面积为10 cm²、7 cm²和3 cm²的橡胶引流片后2小时、4小时和6小时,肠道细菌移位至肠系膜淋巴结,并扩散至全身器官(肝脏、脾脏、肺和肾脏)、门静脉和下腔静脉,术后第2天细菌移位至腹腔内橡胶引流片及腹腔。细菌移位发生率与植入材料的大小及植入后的时间相关。植入7 cm²和10 cm²橡胶引流片后,肠道氧摄取显著增加。植入7 cm²和10 cm²引流片的组回肠黏膜通透性增强。因此,橡胶引流片腹腔内植入后早期即发生细菌移位,并随时间增加。肠道氧摄取增加表明肠道易受腹腔内炎症刺激,回肠通透性增强提示胃肠道完整性受损,这可能促进细菌移位。

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