S3神经根电刺激改善急性完全性脊髓损伤后肠黏膜屏障功能

Role of electrical stimulation of S 3 nerve root in improvement of intestinal mucosal barrier function after acute complete spinal cord injury in rabbits

目的探讨S3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拭瘫模型，以截瘫后行S，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、肠系膜淋巴结作细闰培养并进行蔺种鉴定。取实验组和对照组各动物的肝、睥、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S3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，细菌移位牢明显下降。结论急性脊髓损伤后电刺激S3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。

Objective To investigate the effect of electrical stimulation of S 3 nerve root on im- provement of intestinal mucosal barrier function in rabbits with acute complete spinal cord injury. Meth- ods Model of paraplegia was built by injuring spinal cord in rabbits. Then, the rabbits with electrieal stimulation of S 3 nerve mot 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 cuhure; and liver, spleen and mesenteric lymph nodes were col- lected for bacterial culture and strain identification. Liver, spleen, mesenteric lymph nodes and small in- testines 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 intesti- nal mucosal 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 ex- perimental group, the electrical stimulation of S3 nerve root could improve motility of the denervated intes- tine, with more defecation content, less destruction of the intestinal mucosa and lighter other organ dam- age compared with control group, serum endotoxin level was significantly reduced eompared 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 S3 nerve root can facilitate intestinal tract motility, improve intestinal mueosal barrier function and hence alleviate endotoxemia and intestinal bacterial transloeation, as is beneficial to reducing SIRS and MODS.