严重烫伤休克期肠道运动功能的改变及意义

Changes and Significance of Movement Function of Intestine in Severe Scalding Shock Stage

目的 :观察严重烫伤休克期小鼠小肠 ,豚鼠结肠推进功能的改变 ,为烧伤临床肠动力功能的维护和肠源性感染的防治提供理论依据。方法 :采用 2 0 %小鼠背部和 30 %豚鼠背部 (TBSA) 度烫伤模型 ,对烧伤休克期小鼠小肠、豚鼠结肠运动功能进行动态观察。结果 :小鼠伤后 3h肠推进功能显著降低 ,6 h继续下降 ,12 h降至最低值 ;伤后 2 4h开始回升 ,但 48h仍低于对照组。豚鼠伤后 3h结肠推进功能即降至最低值 ,6 h后开始恢复 ,12 h恢复至正常 ,但 2 4h又显著高于正常 ,48h虽有所降低但与对照组相比仍有显著性差异。结论 :严重烫伤休克期小肠运动功能显著受抑 ,而结肠动力功能则先抑制后激惹 ;肠动力功能紊乱可能是肠道细菌及内毒素移位 ,肠源性感染的始发因素 。

Objective:To observe the dynamic changes of intestinal motility in the postburn shock stage and provide information for the prevention and treatment of bacterial infection following burns.Methods:Rat model with 20% TBSA total body snrface area fullthickness thermal injury and guinea pig model with 30% TBSA fullthickness thermal injury were employed and pushing rate of intestine in rat and pushing rate of colon in guinea pig were dynamically measured with 48 hours postburn.Results:In rat at 3 hours postburn,the pushing rates of intestine were already significantly decreased,which were sustained and reached the lowest values at 12 hours postburn.Although pushing rates restored in some degree at 24 hours postburn and it was still statistically lower compared with control group in guinea pig.Pushieng rates of colon were lowest at 3 hours postburn and partly restored at 6 hours postburn and have no statistically significance with control group at 12 hours postburn.But pushing rates of colon were sharply increased at 24 hours postburn and at 48 hours were slightly higher compared with control group.Conclusion:Movement function of small intestine is severely inhibited within 48 hours postburn,and movement function of colon is severely inhibited within 6 hours postburn and over stimulated after 12 hours postburn. Disorder of intestinal motility is initiating factor of bacterial infection follwing burns,in shock stage of burn patients protection of intestinal motility have much important significance.