舱内腹部闭合性爆炸伤对大鼠肠道细菌移位的影响

Effect of Blast Injury on Intestinal Bacterial Translocation in Rats Exploded in Relative Closed Spaces

目的探讨舱内大鼠腹部爆炸伤对肠道细菌移位的影响。方法100只成年SD大鼠随机分为舱内组和舱外组（50只／组），在陆军模拟战斗舱室和舱外开阔地爆炸复制腹部爆炸伤模型，爆炸后3、8、24、48和72h采集门静脉血、外周血和肠系膜淋巴结、肝脏组织进行普通细菌培养并鉴定细菌菌株，同时采用PCR法检测血液细菌DNA。结果组织细菌培养在舱内组大鼠伤后3h即为阳性，而舱外组在伤后8h才出现细菌，四种组织细菌培养总阳性率舱内组为42．0％，舱外组为18．5％（x^2=22．763，P〈0．001），经鉴定阳性细菌绝大部分为大肠埃希菌（81．8％）。舱内组细菌DNA检出率91．0％，舱外组为64．0％（x^2=20．903，P〈0．001）。结论舱内爆炸致大鼠肠道细菌移位较舱外早且发生率高，在早期救治战斗舱室内爆炸伤伤员时需采取有效措施预防肠源性感染。

Objective To investigate effect of blast injury on intestinal bacterial translocation in rats with abdominal wound subjected to explosion in relative enclosed spaces. Methods A total of 100 male rats were distributed randomly into 2 groups ： enclosure and free - field groups subjected to explosion with 600rag DDNP instantaneous electric detonator. Quantitative bacterial cultures and bacterial identification of mesenteric lymph nodes, liver and blood samples in portal vein and peripheral vein were performed at 3 h, 8 h, 24 h, 48 h and 72 h after explosion. Bacterial DNA in the blood samples was also measured by polymerase chain reaction. Results Bacterial cultures were positive at 3 h after trauma in relative closed spaces while at 8h after injury in the open air. The total positive rate of culture in four type of tissues was 42. 0% in enclosure group while 18.5% in flee field group （ X^2 = 22. 763, P 〈 0. 001 ）. Bacterial type was majorly Eseherichia coli （ 81.8% ）. Detection rate of bacterial DNA was 91.0% in the enclosure group while 64. 0% in open space group（x^2 =20. 903, P 〈0. 001 ）. Conclusion The findings of a earlier and higher incidence of intestinal baeterial transloeation in rats with abdominal wound exploded in relative enclosed spaces suggest that it is necessary to take effective measures to prevent enterogenic infection when we treat the wounded soldiers with blast injury in relative battle defence works.