CAJ | 학술논문

目的观察腹腔暴露对大鼠胃肠动力及炎性反应的影响.方法将30只大鼠随机分为对照组(C组)、假手术组(S组)、腹腔暴露1h组(E1组)、腹腔暴露2h组(E2组)和腹腔暴露3h组(E3组),每组6只.E1组、E2组和E3组大鼠开腹后暴露腹腔,但不进行任何手术操作,暴露相应时间后关腹.S组大鼠仅作腹壁切口,但不打开腹腔.C组大鼠仅作麻醉处理.各组大鼠术后24 h进行炭末推进实验后取血液和小肠标本.用酶联免疫吸附试验(ELISA)法检测血清和肠道肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6和IL-10水平;逆转录-聚合酶链反应(RT-PCR)检测TNF-α、IL-1β、IL-6和IL-10的mRNA相对表达水平.结果 C、S、E1、E2和E3组大鼠炭末推进率分别为(62.26 ±8.22)％、(65.27±8.45)％、(58.21±7.26)％、(43.89±6.63)％、(38.62±6.28)％;E2组和E3组明显低于C组(P＜0.05).E1、E2和E3组较C组大鼠血清和肠道的炎性因子浓度有所升高,肠道的炎性因子mRNA相对表达量有所增强,并且这种差异随着腹腔暴露时间的延长而逐渐明显,以E2组或E3组的差异最为显著(P＜0.05).结论腹腔暴露后大鼠胃肠动力功能下降,全身和肠道炎性反应增强,这可能是开腹术后胃肠功能恢复较腹腔镜术后慢的一个重要原因.
목적 관찰복강폭로대대서위장동력급염성반응적영향.방법 장30지대서수궤분위대조조(C조)、가수술조(S조)、복강폭로1h조(E1조)、복강폭로2h조(E2조)화복강폭로3h조(E3조),매조6지.E1조、E2조화E3조대서개복후폭로복강,단불진행임하수술조작,폭로상응시간후관복.S조대서부작복벽절구,단불타개복강.C조대서부작마취처리.각조대서술후24 h진행탄말추진실험후취혈액화소장표본.용매련면역흡부시험(ELISA)법검측혈청화장도종류배사인자-α(TNF-α)、백세포개소-1β(IL-1β)、IL-6화IL-10수평;역전록-취합매련반응(RT-PCR)검측TNF-α、IL-1β、IL-6화IL-10적mRNA상대표체수평.결과 C、S、E1、E2화E3조대서탄말추진솔분별위(62.26 ±8.22)％、(65.27±8.45)％、(58.21±7.26)％、(43.89±6.63)％、(38.62±6.28)％;E2조화E3조명현저우C조(P＜0.05).E1、E2화E3조교C조대서혈청화장도적염성인자농도유소승고,장도적염성인자mRNA상대표체량유소증강,병차저충차이수착복강폭로시간적연장이축점명현,이E2조혹E3조적차이최위현저(P＜0.05).결론 복강폭로후대서위장동력공능하강,전신화장도염성반응증강,저가능시개복술후위장공능회복교복강경술후만적일개중요원인.
Objective To investigate the effect of peritoneal air exposure on intestinal motility and intestinal inflammation.Methods Thirty rats were randomized into five groups:a control group (C),a sham group (S),and three exposure groups with peritoneal air exposure for 1,2 and 3 h (E1,E2,E3),respectively (n =6 each).At 24 h after surgery,gastrointestinal transit was assessed by charcoal transport; twenty minutes later,systemic inflammation was assessed by serum tumour necrosis factor (TNF)-α,interleukin (IL)-1β,IL-6 and IL-10 concentrations; and intestinal inflammation was assessed by the concentrations and gene expression of TNF-α,IL-1β,IL-6 and IL-10.Results The gastrointestinal transit in C,S,E1,E2,E3 group was (62.26 ± 8.22)％,(65.27 ± 8.45)％,(58.21 ±7.26)％,(43.89 ± 6.63) ％,(38.62 ± 6.28) ％,respectively; E2 and E3 group showed a lower level in gastrointestinal transit than C group (P ＜ 0.05).In addition,E1,E2 and E3 group showed an increase in the concentrations of serum and intestinal inflammatory cytokines,and an increase in the relative expression of intestinal inflammatory cytokines when compared with C group.Furthermore,we found that this difference was proportional to the incremental time length of peritoneal air exposure,differed significantly in E2 or E3 group (P ＜ 0.05).Conclusion The data suggest that the time length of peritoneal air exposure is proportional to the degree of intestinal motility and the activation of systemic and intestinal inflammation.This injury induced by peritoneal air exposure may be a key factor contributing to the longer time recovery of gastrointestinal function after open abdominal surgery than that after laparoscopic surgery.