选择性肠道去污染对大鼠极限肝切除预后的影响

Selective bowel decontamination improves the prognosis of extended hepatectomy in rats

目的探讨选择性肠道去污染对改善大鼠90％肝切除术预后的影响。方法sD大鼠分为选择性肠道去污染（SBD）组和对照组，分别在术前使用庆大霉素、多黏菌素、制霉菌素的三联抗生素和等量生理盐水进行灌胃，随后均接受90％肝切除术（SHx）。术后采用多种方法对血清脂多糖（LPS）、肝功能、肝脏组织损伤、肠黏膜屏障损伤、炎症相关信号通路及肝再生等指标进行检测方法。结果90％肝切除术可显著提高大鼠循环血内的LPS水平。术前SBD可抑制肠道革兰氏阴性菌的生长、改善肠道黏膜屏障损伤、降低内毒素血症的发生率；减轻肝功能损害，减少肝实质炎症反应，改善肝再生，从而改善预后。结论术前SBD可显著改善极限肝切除术的预后。

Objective To investigate the effect of selective bowel decontamination （SBD） on prog- nosis of 90% hepatectomy in rats. Methods We adopted rat model of subtotal hepatectomy（90%, SHx）, gentamicin ＋ polymyxin ＋ nystatinor saline of the same amount was administrated preoperatively. Liver damage makers, portal and systemic lipopolysaccharide（LPS） , mucosal damage, signaling pathways and liv- er regeneration were investigated. Results We found that SHx resulted in significantly enhancedsystemic LPS. Inhibition of gastrointestinal gram-negative bacteria by SBD significantly reduced LPS levels and im- proved survival after SHx. SBD protected intestinal mucosa barrier, alleviated liver parenchymal damage and inflammation and promoted liver regeneration. Conclusion SBD is beneficial and necessary for extended heptactomy.