选择性肠道去污染对创伤性截瘫家兔肠道细菌移位的影响

Effects of Selective Digestive Tract Decontamination on Intestinal Bacterial Translocation in Rabbits with Traumatic Paraplegia

目的探讨选择性肠道去污染(SDD)在改善截瘫家兔肠道细菌移位中的作用。方法通过建立截瘫家兔模型,应用PTA方案对截瘫家兔SDD处理4天后采集门静脉血和外周血行细菌培养、菌株鉴定及DNA检测。结果对照组家兔门静脉血14例、外周血9例细菌培养阳性;而处理组门静脉血、外周血细菌培养阳性者分别仅为3例、6例,组间比较有统计学意义(P<0.05)。阳性细菌菌株鉴定主要为大肠埃希菌和肠球菌(占88%)。对照组全部截瘫家兔门静脉血均检测出细菌DNA,而处理组仅有8例检测出(P<0.001);外周血细菌DNA检测阳性在处理组有6例、对照组16例(P=0.001)。结论 SDD处理截瘫家兔可明显减轻肠道细菌移位,是一种安全、经济的预防肠源性感染的有效治疗手段,具有一定的临床实用价值。

Objective To discuss the role of selective digestive tract decontamination(SDD)in improving intestinal bacterial translocation in paraplegia rabbits.Methods The paraplegic rabbit model was established and the bacterial culture,strain identification and DNA detection were performed in portal vein blood and peripheral blood of paraplegic rabbits treated with SDD for 4 days with PTA regimen.Results In the control group,the cultures of 14 rabbits venous blood and 9 rabbits peripheral blood were positive;while in the treatment group,only 3 cases and 6 cases were positive in portal and peripheral blood bacterial culture,and the comparison between the two groups was statistically significant(P<0.05).The positive bacterial strains were mainly Escherichia coli and enterococcus(88%).Bacterial DNA was detected in the venous blood of all the paraplegic rabbits in the control group,while only 8 cases were detected in the treatment group(P<0.001);6 cases in the treatment group and 16 cases in the control group were positive in peripheral blood bacteria DNA detection(P=0.001).Conclusion SDD treatment of paraplegia rabbit can significantly reduce intestinal bacterial translocation,which is a safe and economic effective treatment for prevention of enterogenous infection and has a certain clinical practical value.