大鼠失血性休克复苏早期肠黏膜损伤与修复的形态学观察

Study on morphological change in intestinal mucosa from injury to repair after hemorrhagic shock

目的 观察失血性休克复苏后早期 ,大鼠肠黏膜损伤修复的形态学特征。方法 建立失血性休克致肠缺血再灌注模型 ,通过光镜和电镜观察不同阶段肠黏膜的改变及肠上皮损伤指数。结果 从复苏 0 h起回肠和空肠肠道上皮就发生明显的损伤改变 ,至 3h损伤改变仍然存在 ,以 1h最为明显 ;3h起部分肠黏膜即出现修复现象 ,6 h大部分黏膜已修复 ,2 4 h肠黏膜结构恢复正常 ;大肠与小肠在损伤和修复的变化过程方面基本相同 ,但其程度明显低于小肠 ;小肠黏膜厚度和绒毛高度 1h后逐渐减少 ,大肠各组间则无明显变化。结论 失血性休克致肠缺血再灌注损伤早期肠黏膜屏障受累 ,同时损伤的肠黏膜能够得到快速修复重建 。

Objective To study on morphological changes in mucosa of the small and large intestine mucosa after resuscitation of hemorrhagic shock. Methods The morphological changes in intestinal mucosa were observed under light and electron microscope, including the histology of intestinal mucosa, determination of height of villi and evaluation of mucosa damage index in the different phases after traumatic hemorrhagic shock. Results Mucosa epithelial injury was obvious in small intestine were even at 0 hour, becoming more serious in 1 hour up to 3 hours. The tissue repair began after 3 hours, though the injury was still serious. Most of the injured mucosa began to repair after 6 hours, and completed in 24 hours. The condition of the large intestine was similar to that of the small intestine, but the injury was less severe. The mucosal thickness and the height of villi were diminished after 1 hour of shock, but there was no obvious change in the colon. Conclusion In the early phase after hemorrhagic shock, intestinal mucosal barrier are subjected to damage, but it could repair and recover in a short time. Compare with small intestine, large intestine have stronger potentiality against injury.