不同pH值灌肠液对兔肠黏膜损伤的实验研究

Experimental study on injures of rabbit intestinal mucosa caused by enema with different pH

目的观察不同pH值灌肠液对兔肠黏膜的损伤情况。方法将60只家兔随机分成三组,分别用生理盐水、肥皂水、食醋灌肠。观测灌肠前后血钾水平变化以及粪便涂片肠黏膜细胞脱落情况。并将动物腹腔麻醉下取直肠、结肠远心回、结肠近心回肠壁制作病理切片,透射电镜观察肠黏膜细胞亚显微结构变化;光镜观察肠黏膜充血、水肿情况。结果 (1)肥皂水组、食醋组灌肠后血钾下降水平显著高于生理盐水组;(2)肥皂水组、食醋组直肠部位以及结肠远心回肠黏膜损伤程度较生理盐水组直肠部位轻;而各组内不同部位损伤程度比较,直肠部位损伤最重,结肠远心回其次,结肠近心回最轻;(3)生理盐水组黏膜细胞亚显微结构基本无改变或轻度损伤,黏膜上皮层完整。肥皂水及食醋组可见细胞损伤较严重,部分柱状细胞微绒毛减少、消失,细胞变形,内质网水肿,细胞核固缩、染色质边集。甚者细胞脱落、坏死,上皮层缺失;(4)生理盐水组粪便涂片基本无脱落肠黏膜细胞,部分可见散在数个黏膜细胞。肥皂水组及食醋组均可见成团或片状黏膜细胞。结论酸性、碱性灌肠液对肠黏膜损伤较中性灌肠液严重。

Objective To study the injures of rabbit＇s intestinal mucosa caused by enema with different pH.Method 60 rabbits was randomly divided into 3 groups.Each group was enema with normal sodium,soapsuds and vinegar respectively.The level of serum potassium before and after the enema was detected.Besides measuring the colorectal exfoliative cells from stool smear,the pathological sections of rectum,distal and proximal part of colon are conducted in the situation of intra-peritoneal injection anesthesia.The congestion and edema of intestinal mucous membrane was observed through microscope and ultra-micro-structure of intestinal cells through electron microscope. Result 1.Level of serum potassium after coloclysis in soapsuds group and vinegar group are much higher than that of the normal sodium group.2.More serious injuries can be observed on rectum and distal part of colon in soapsuds group and vinegar group compared to normal sodium-group.However,comparison with different parts in each group,injuries to rectum is the most serious,and the next is distal part of colon,the least is the proximal part of colon.3.Endothelial layers of intestinal mucosa in normal sodium group are integrated.Most of microvillus of pillar cell in soapsuds group and vinegar group are lost or even disappeared.Mitochondrion and endocytoplasmic reticulum appeared edema,as well as karyopyknosis and chromatin margination.To make things even worse,some samples seriously destroyed can＇t even distinguish the construction.Lots of exfoliated and necrosis cells can be found.4. There is less or no colorectal exfoliative cells from stool smear in normal sodium-group.However many mucous membrane cells can be found in soapsuds-group and vinegar-group.Conclusion Edema with pH of acidity and alkalinity have more serious injuries to intestinal membrane than that of neutral liquid.