不同类型肠梗阻血清中丙二醛的测定和细菌移位的实验研究

An experimental study of serum malondialdehyde content and bacterial translocation in various kinds of bowel obstruction

目的：比较在不同类型肠梗阻中和不同范围绞窄性肠梗阻中丙二醛（ Ｍ Ｄ Ａ）的差异和细菌移位情况；并观察 Ｍ Ｄ Ａ和细菌移位的相互关系。方法：健康１ 月龄新西兰小兔４０ 只，随机分成三组并制成不同的模型：（１）绞窄性肠梗阻组（简称 Ａ组）。（２）单纯性肠梗阻组（简称 Ｂ组）。（３）对照组（简称 Ｃ组）。测定各种肠梗阻前和梗阻１２ ｈ 后血清中 Ｍ Ｄ Ａ的含量，并行血细菌培养。结果： Ａ 组 Ｍ Ｄ Ａ 明显高于 Ｂ组和 Ｃ组（ Ｐ＜ ０．０５ 和 Ｐ＜ ０．０１）；而 Ｂ组和 Ｃ组无差异；绞窄肠袢范围大者 Ｍ Ｄ Ａ 高于范围小者（ Ｐ＜ ０．０５）。 Ａ＋ Ｂ组细菌移位发生率高于 Ｃ组（ Ｐ＜ ０．０５）； Ａ组细菌移位发生率高于 Ｂ组（ Ｐ＜ ０．０１）， Ｂ组与 Ｃ组无差异，肠袢绞窄范围大小与细菌移位发生率无关。结论：自由基的测定和细菌移位的监测在临床上对肠梗阻类型的诊断、绞窄肠袢范围的判断、治疗方案和手术时机的选择及预后估计都具有指导意义。

Objective:To compare serum malondialdehyde (MDA) content and bacterial translocation in various kinds of bowel obstruction and in those with different lengths of intestinal loop strangulated.The relation between serum MDA content and the incidence of bacterial translocation was also studied.Methods:40 healthy New Zealand rabbits were divided into 3 groups and made to be different kinds of mode:Group A with strangulated bowel obstruction;Group B with simple obstruction and Group C as control.Serum MDA content were measured 12 hours after obstruction and blood cultures also taken.Results: Serum MDA contents in Group A were markedly higher than those in Group B and Group C( P< 0.05 and P <0.01),whilst there was no difference between Group B and Group C.Regarding to Group A itself,there were higher MDA contents in Group A 100 with the long strangulated bowel loop than those in Group A 40 with the short one ( P <0.05).The incidence of bacterial translocation in which no difference was seen between Group B and Group C,was higher in Group A + Group B than in Group C( P <0.05),was higher in Group A than in Group B( P < 0.01 ).Between the length of bowel strangulated and this incidence no correlation could be found.Conclusious:In clinical point of view it is of significance to monitor free radical and to watch for bacterial translocation for establishing a precise diagnosis of bowel obstraction in detail,evaluating the relative length of bowel loop strangulated,deciding what kind of and when the surgical procedure to perform and at last for the prognosis forecasting.