组织氧分压测定缺血再灌注肠管生机的实验研究

Application of tissue oxygen tension measurements for the determination of intestinal viability.

目的 探讨大白兔组织氧分压与缺血再灌注肠管生机的关系。方法 将 2 0只大白兔随机分成A、B、C、D四组 ,缺血时间分别为 1、2、3、4小时 ,再灌注时间均为 2 4小时 ,应用二通道组织氧测定仪及氧分压传感针测定缺血前、缺血及再灌注过程中的肠肌层氧分压值 ,2 4小时灌注时间到达后立即取该段肠管作组织病理学检查 ,并分析氧分压与病理组织结果的相关性。结果 正常情况下组织氧分压为 (8.4± 1.6 )kPa。A、B、C、D四组缺血末的氧分压分别为 (4 .1± 1.5 )kPa、(2 .9± 0 .6 )kPa、(1.9± 0 .7)kPa、(0 .9± 0 .2 )kPa,再灌注 2 4小时氧分压分别为 (6 .9± 0 .9)kPa、(6 .2± 1.1)kPa、(3.1± 0 .7)kPa、(2 .8± 0 .4)kPa。病理结果显示A、B两组损伤轻 ,C、D两组损伤严重 ,A、B两组与C、D两组差异显著。病理结果与缺血末、再灌注 30分钟、再灌注 2 4小时的氧分压的相关系数分别为 - 0 .6 3(P <0 .0 1)、 - 0 .70 (P <0 .0 1)、 - 0 .89(P <0 .0 1)。结论 组织氧分压测定可用于缺血再灌注肠管生机的评估。

Objective To evaluate the ability of tissue oxygen tension to determine the intestinal viability. Methods Twenty albino rabbits were divided into four groups randomly.An isolated ischemic bowel loop was made in each rabbit and the clamping and rubber bands were released at intervals of 1,2,3 and 4 h in different groups. Tissue oxygen tensions were measured before ischemia and during ischemia/reperfusion by using PO 2 sensor needle. The histopathological examination of the involved intestines were made 24 hours after reperfusion. The correlation between PO 2 and the pathological features was analyzed. Results The tissue oxygen tension was ( 8.4 ± 1.6 ) kPa before ischemia.PiO 2 in the four groups was ( 4.1 ± 1.5 ) kPa, ( 2.9 ± 0.6 ) kPa, ( 1.9 ± 0.7 ) kPa, ( 0.9 ± 0.2 ) kPa in the end of the ischemia respectively. PiO 2 in the four groups was ( 6.9 ± 0.9 ) kPa, ( 6.2 ± 1.1 ) kPa, ( 3.1 ± 0.7 ) kPa and ( 2.8 ± 0.4 ) kPa 24 h after reperfusion respectively. The pathogical examination revealed that the lesion was mild in the groups A and B, while the lesion was severe in the groups C and D, indicating a negative correlation between the pathological degree and PiO 2 ( r =- 0.63 , - 0.70 , -0.89 respectively, all P < 0.01 ).Conclusion Measurement of the tissue oxygen tension may be a useful method to assess the intestinal viability.