CAJ | 학술논문

目的探讨S_3神经根电刺激对急性完全性脊髓损伤后肠黏膜屏障功能障碍的作用. 方法建立兔脊髓损伤性截瘫模型,以截瘫后行S_3神经根电刺激为实验组,不做刺激截瘫兔为对照组,正常白兔为正常组.无菌条件下,采集门静脉血进行内毒素定量测定和细菌培养,采集肝、脾、肠系膜淋巴结作细菌培养并进行菌种鉴定.取实验组和对照组各动物的肝、脾、肠系膜淋巴结、小肠进行病理切片HE染色检查,取小肠进行电镜检查. 结果对照组肠黏膜屏障及其他器官破坏严重,血清内毒素水平较实验组和正常组明显增高,肠道菌群移位发生率较高;实验组电刺激S_3神经根使失神经肠道蠕动增强,排出的肠内容物明显增加,同时肠黏膜破坏较轻,其他脏器损伤也较对照组轻,血清内毒素水平较对照组明显减轻并且与正常组差异无统计学意义,细菌移位率明显下降. 结论急性脊髓损伤后电刺激S_3神经根能较好地促进肠道蠕动,促进肠内容物的排出,良好地改善肠黏膜屏障功能,进而减轻内毒素血症和肠道细菌移位;有利于减少SIRS和MODS的产生.
목적 탐토S_3신경근전자격대급성완전성척수손상후장점막병장공능장애적작용. 방법 건립토척수손상성절탄모형,이절탄후행S_3신경근전자격위실험조,불주자격절탄토위대조조,정상백토위정상조.무균조건하,채집문정맥혈진행내독소정량측정화세균배양,채집간、비、장계막림파결작세균배양병진행균충감정.취실험조화대조조각동물적간、비、장계막림파결、소장진행병리절편HE염색검사,취소장진행전경검사. 결과 대조조장점막병장급기타기관파배엄중,혈청내독소수평교실험조화정상조명현증고,장도균군이위발생솔교고;실험조전자격S_3신경근사실신경장도연동증강,배출적장내용물명현증가,동시장점막파배교경,기타장기손상야교대조조경,혈청내독소수평교대조조명현감경병차여정상조차이무통계학의의,세균이위솔명현하강. 결론 급성척수손상후전자격S_3신경근능교호지촉진장도연동,촉진장내용물적배출,량호지개선장점막병장공능,진이감경내독소혈증화장도세균이위;유리우감소SIRS화MODS적산생.
Objective To investigate the effect of electrical stimulation of S_3 nerve root on improvement of intestinal mucosal barrier function in rabbits with acute complete spinal cord injury. Methods Model of paraplegia was built by injuring spinal cord in rabbits. Then, the rabbits with electrical stimulation of S_3 nerve root were set as experimental group and those without set as control group. Normal rabbits were set as normal group. Under aseptic condition, portal vein blood was collected for quantitative determination of endotoxin and bacterial culture ; and liver, spleen and mesenteric lymph nodes were collected for bacterial culture and strain identification. Liver, spleen, mesenteric lymph nodes and small intestines were collected from experimental group and control group for pathological HE staining; while small intestine were observed by light and electron microscopes. Results In control group, the intestinal mueosal barrier and the other organs were destroyed obviously, with higher level of Serum endotoxin and higher rate intestinal flora translocation than that in experimental group and normal group. In the experimental group, the electrical stimulation of S_3 nerve root could improve motility of the denervated intestine, with more defecation content, less destruction of the intestinal mucosa and lighter other organ damage compared with control group, serum endotoxin level was significantly reduced compared with control group but showed no statistical difference compared with normal group, with obvious decrease of bacterial translocation rate. Conclusions After spinal cord injury in rabbits, electrical stimulation of S_3 nerve root can facilitate intestinal tract motility, improve intestinal mucosal barrier function and hence alleviate endotoxemia and intestinal bacterial translocation, as is beneficial to reducing SIRS and MOBS.