中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
CHINESE JOURNAL OF NAUTICAL MEDICINE AND HYPERBARIC MEDICINE
2012年
5期
271-275,283
,共6页
李欣%吴姗珊%刘超群%浦江%付山峰%段蕴铀%孙涛
李訢%吳姍珊%劉超群%浦江%付山峰%段蘊鈾%孫濤
리흔%오산산%류초군%포강%부산봉%단온유%손도
海水浸泡%腹部开放伤%肠功能%谷氨酰胺
海水浸泡%腹部開放傷%腸功能%穀氨酰胺
해수침포%복부개방상%장공능%곡안선알
Seawater immersion%Open abdominal injury%Intestinal function%Glutamine%Therapeutic effect
目的 探讨谷氨酰胺对腹部开放伤后海水浸泡实验犬肠功能的影响.方法 30只成年犬致腹部开放伤,按数字表法随机分为海水浸泡组(对照组)、普通治疗组(常规组)和谷氨酰胺治疗组(观察组),每组10只.于致伤前及致伤后定时测定犬的血压、心率、呼吸、腹围、肠鸣音,取血测定内毒素、D-乳酸、双胺氧化酶(DAO)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)和尿乳果糖/甘露醇(L/M),24 h后取小肠组织进行病理检查并测量肠黏膜厚度和绒毛高度.结果 与常规组比较,观察组平均动脉压、心率、呼吸、肠鸣音和腹围差异均无统计学意义(P＞0.05),对照组与常规组、观察组比较,平均动脉压、肠鸣音差异均有统计学意义(P＜0.05),致伤后12h和24 h时间点心率差异均有统计学意义(P＜0.05),致伤后24h时间点呼吸差异有统计学意义(P＜0.05),致伤后24h时间点腹围差异有统计学意义(P＜0.05).内毒素:对照组与常规组、观察组比较,致伤后12 h和24 h时间点差异均有统计学意义(P＜0.05),观察组与对照组、常规组比较,在24h时间点差异均有统计学意义(P＜0.05).D-乳酸:致伤后12 h时间点,常规组与对照组、观察组差异均有统计学意义(P＜0.05),观察组和对照组之间差异无统计学意义(P＞0.05);致伤后24 h时间点,常规组与对照组、观察组差异均有统计学意义(P＜0.05),观察组和对照组之间差异无统计学意义(P＞0.05).DAO:观察组与对照组、常规组比较,致伤后8h与24 h时间点差异均有统计学意义(P＜0.05).TNF-α:观察组与对照组、常规组比较,致伤后12 h与24 h时间点差异均有统计学意义(P＜0.05).IL-1:致伤后12 h时间点,常规组[(8.71±3.13)ng/L]与对照组[(7.40±2.71)ng/L]、观察组[(6.34±1.83)ng/L]差异均有统计学差异(P＜0.05),观察组和对照组差异无统计学意义(P＞0.05);致伤后24 h时间点,观察组[(7.44±3.11)ng/L]与对照组[(9.91±3.18)ng/L]、常规组[(10.12±2.25)ng/L]差异均有统计学意义(P＜0.05).尿L/M值:观察组(0.10±0.06)与对照组(1.07±0.04)、常规组(1.09±0.09)差异有统计学意义(P＜0.05).病理结果:观察组光镜下肠黏膜可见轻度水肿,与常规组、对照组比较明显减轻;观察组小肠黏膜厚度和绒毛高度与常规组比较差异均有统计学意义(P＜0.05);对照组与常规组比较差异均无统计学意义(P＞0.05).结论 谷氨酰胺对腹部外伤后海水浸泡导致的肠功能损伤有明确的治疗作用.
目的 探討穀氨酰胺對腹部開放傷後海水浸泡實驗犬腸功能的影響.方法 30隻成年犬緻腹部開放傷,按數字錶法隨機分為海水浸泡組(對照組)、普通治療組(常規組)和穀氨酰胺治療組(觀察組),每組10隻.于緻傷前及緻傷後定時測定犬的血壓、心率、呼吸、腹圍、腸鳴音,取血測定內毒素、D-乳痠、雙胺氧化酶(DAO)、腫瘤壞死因子-α(TNF-α)、白細胞介素-1(IL-1)和尿乳果糖/甘露醇(L/M),24 h後取小腸組織進行病理檢查併測量腸黏膜厚度和絨毛高度.結果 與常規組比較,觀察組平均動脈壓、心率、呼吸、腸鳴音和腹圍差異均無統計學意義(P＞0.05),對照組與常規組、觀察組比較,平均動脈壓、腸鳴音差異均有統計學意義(P＜0.05),緻傷後12h和24 h時間點心率差異均有統計學意義(P＜0.05),緻傷後24h時間點呼吸差異有統計學意義(P＜0.05),緻傷後24h時間點腹圍差異有統計學意義(P＜0.05).內毒素:對照組與常規組、觀察組比較,緻傷後12 h和24 h時間點差異均有統計學意義(P＜0.05),觀察組與對照組、常規組比較,在24h時間點差異均有統計學意義(P＜0.05).D-乳痠:緻傷後12 h時間點,常規組與對照組、觀察組差異均有統計學意義(P＜0.05),觀察組和對照組之間差異無統計學意義(P＞0.05);緻傷後24 h時間點,常規組與對照組、觀察組差異均有統計學意義(P＜0.05),觀察組和對照組之間差異無統計學意義(P＞0.05).DAO:觀察組與對照組、常規組比較,緻傷後8h與24 h時間點差異均有統計學意義(P＜0.05).TNF-α:觀察組與對照組、常規組比較,緻傷後12 h與24 h時間點差異均有統計學意義(P＜0.05).IL-1:緻傷後12 h時間點,常規組[(8.71±3.13)ng/L]與對照組[(7.40±2.71)ng/L]、觀察組[(6.34±1.83)ng/L]差異均有統計學差異(P＜0.05),觀察組和對照組差異無統計學意義(P＞0.05);緻傷後24 h時間點,觀察組[(7.44±3.11)ng/L]與對照組[(9.91±3.18)ng/L]、常規組[(10.12±2.25)ng/L]差異均有統計學意義(P＜0.05).尿L/M值:觀察組(0.10±0.06)與對照組(1.07±0.04)、常規組(1.09±0.09)差異有統計學意義(P＜0.05).病理結果:觀察組光鏡下腸黏膜可見輕度水腫,與常規組、對照組比較明顯減輕;觀察組小腸黏膜厚度和絨毛高度與常規組比較差異均有統計學意義(P＜0.05);對照組與常規組比較差異均無統計學意義(P＞0.05).結論 穀氨酰胺對腹部外傷後海水浸泡導緻的腸功能損傷有明確的治療作用.
목적 탐토곡안선알대복부개방상후해수침포실험견장공능적영향.방법 30지성년견치복부개방상,안수자표법수궤분위해수침포조(대조조)、보통치료조(상규조)화곡안선알치료조(관찰조),매조10지.우치상전급치상후정시측정견적혈압、심솔、호흡、복위、장명음,취혈측정내독소、D-유산、쌍알양화매(DAO)、종류배사인자-α(TNF-α)、백세포개소-1(IL-1)화뇨유과당/감로순(L/M),24 h후취소장조직진행병리검사병측량장점막후도화융모고도.결과 여상규조비교,관찰조평균동맥압、심솔、호흡、장명음화복위차이균무통계학의의(P＞0.05),대조조여상규조、관찰조비교,평균동맥압、장명음차이균유통계학의의(P＜0.05),치상후12h화24 h시간점심솔차이균유통계학의의(P＜0.05),치상후24h시간점호흡차이유통계학의의(P＜0.05),치상후24h시간점복위차이유통계학의의(P＜0.05).내독소:대조조여상규조、관찰조비교,치상후12 h화24 h시간점차이균유통계학의의(P＜0.05),관찰조여대조조、상규조비교,재24h시간점차이균유통계학의의(P＜0.05).D-유산:치상후12 h시간점,상규조여대조조、관찰조차이균유통계학의의(P＜0.05),관찰조화대조조지간차이무통계학의의(P＞0.05);치상후24 h시간점,상규조여대조조、관찰조차이균유통계학의의(P＜0.05),관찰조화대조조지간차이무통계학의의(P＞0.05).DAO:관찰조여대조조、상규조비교,치상후8h여24 h시간점차이균유통계학의의(P＜0.05).TNF-α:관찰조여대조조、상규조비교,치상후12 h여24 h시간점차이균유통계학의의(P＜0.05).IL-1:치상후12 h시간점,상규조[(8.71±3.13)ng/L]여대조조[(7.40±2.71)ng/L]、관찰조[(6.34±1.83)ng/L]차이균유통계학차이(P＜0.05),관찰조화대조조차이무통계학의의(P＞0.05);치상후24 h시간점,관찰조[(7.44±3.11)ng/L]여대조조[(9.91±3.18)ng/L]、상규조[(10.12±2.25)ng/L]차이균유통계학의의(P＜0.05).뇨L/M치:관찰조(0.10±0.06)여대조조(1.07±0.04)、상규조(1.09±0.09)차이유통계학의의(P＜0.05).병리결과:관찰조광경하장점막가견경도수종,여상규조、대조조비교명현감경;관찰조소장점막후도화융모고도여상규조비교차이균유통계학의의(P＜0.05);대조조여상규조비교차이균무통계학의의(P＞0.05).결론 곡안선알대복부외상후해수침포도치적장공능손상유명학적치료작용.
Objective To investigate the effects of glutamine on intestinal functions of dogs following abdominal open injury coupled with seawater immersion.Methods Following open abdominal injury,30 adult dogs were randomly divided into 3 groups:the seawater immersion group(the control group),the routine treatment group(the conventional group)and the glutamine treatment group(the observation group),each consisting of 10 animals.Blood pressure,heart rate,respiration,abdominal circumference,bowel sound were monitored both before and after injury.Blood samples were collected for the detection of endotoxin,D-lactate,diamine oxidase(DAO),tumor necrosis factor alpha(TNF-a),interleukin-1(IL-1 and lactulose/mannitol(L/M)ratio.After 24 hours,small intestine tissues were taken for pathological detection and measurement of intestinal mucosal thickness and villous height.Results When compared with the conventional group,no statistically significant differences could be seen in mean artery pressure(MAP),heart rate,respiration,bowel sound and abdominal circumference for the observation group(P＞0.05).When compared with the conventional group and the observation group,significant differences could be noted in MAP and bowel sound for the control group(P＜0.05).And statistical significance could also be noted for heart rate,respiration and abdominal circumference at hours 12 and 24 respectively following injury(P＞0.05).Endotoxin:when compared with the conventional and observation groups,statistical significance could also be noted in endotoxin for the control group at hours 12 and 24 following injury(P＞0.05),and statistical significance could also be noticed for the observation group at hour 24,when compared with the control and conventional groups(P＞0.05).D-lactate:there were statistically significant differences for the conventional group,when comparisons were made between the 3 groups at hour 12 following injury(P＜0.05),however,no statistical significance could be noted between the observation group and the control group(P＞0.05).Statistical significance was observed for the conventional group,when compared with the control and observation groups(P＜0.05).And no statistical significance was noted,when a comparison was made between the observation and control groups(P＜0.05).DAO:when compared with the control and conventional groups,statistical significance could be noted for the observation group at hours 8 and 24 respectively following injury(P＜0.05).TNF-α:when compared with observation and conventional groups,there was statistical significance for the observation group at hours 12 and 24 respectively following injury(P＜0.05).IL-1:when compared with the control[(7.40±2.71)ng/L]and the conventional groups[(8.71±3.13)ng/L],statistical significance could be observed for the observation group at hour 12 following injury(P＜0.05),however no statistical significance could be noted,when a comparison was made between the observation and control groups.At hour 24 following injury,when compared with the control[(9.91±3.18)ng/L]and conventional groups[(10.12±2.25)ng/L],statistical significance could be noticed for the observation group(P＜0.05).Urine L/M ratio:statistical significance would be noticed for the observation group,when compared with the control and conventional groups(P＜0.05).Pathological results:only mild edema could be seen in the intestinal mucosal cells of the animals in the observation group under optical microscope,which was obviously lighter,when compared with the observation and control groups.And there were statistical differences in intestinal mucosal thickness and villous height,when compared with the conventional group(P＜0.05),however,no statistical differences could be noted,when a comparison was made between the control and conventional groups(P＞0.05).Conclusions Glutamine seems to have definitive therapeutic effects on intestinal dysfunction induced by abdominal injury coupled with seawater immersion.
