稀释络合碘对大鼠腹腔内炎症与粘连影响的实验研究
发布时间：2018-06-13 09:41
本文选题：脓毒血症 + 腹腔内感染 ； 参考：《南华大学》2013年硕士论文
【摘要】：目的：观察不同浓度络合碘对脓毒症模型中大鼠腹腔内炎症的治疗作用及腹腔内粘连的影响，为术中使用络合碘液预防和治疗腹腔内炎症与粘连提供实验依据。 方法：1.将84只SD实验大鼠适应性分笼喂养一周，按随机数字表随机分为正常生理盐水组（A），，1：5稀释络合碘组（B），1：10稀释络合碘组（C），1：20稀释络合碘组（D），模型组（E），假手术组（F）。2.A，B，C，D，E五组大鼠，以7号丝线结扎距盲肠盲端1cm处，用18号针头刺穿盲肠，并挤出少许粪便，建立SD大鼠盲肠结扎穿孔术(Cecal ligation and puncture,CLP)腹膜炎动物模型，观察各组96小时大鼠存活率，F组仅仅打开腹腔，翻动肠管。3.建模24h后，A，B，C，D四组均解除盲肠结扎梗阻，并关闭盲肠穿孔处，分别用生理盐水，1:5稀释络合碘，1:10稀释络合碘，1:20稀释络合碘清洗腹腔，E组仅解除盲肠结扎梗阻及盲肠漏口关闭，六组大鼠在腹腔清洗术后第1天和术后第3天，取血ELISA检测血浆中IL-6，TNFα表达；4.术后第3天，各组均处死3只大鼠取回肠末端组织及肝脏组织行病理观察。5.术后第10天处死各组所有大鼠，参考Nair5级分类法评估大鼠腹腔粘连程度，取腹腔内粘连组织HE染色观察粘连组织病理变化及CollagenⅠ免疫组化表达。 结果：1.建模后96小时内，A，B，C，D，E五组均出现有大鼠死亡，其中死亡率以E组最高，高达40%；B，C两组死亡率较低，分别与各组比较有统计学意义（P＜0.05）。2.腹腔清洗术后第1天各组TNF-α及IL-6指标均升高，其中模型组(E组)升高最显著，与其他各实验组比较有差异性具有统计学意义（P＜0.05）；F组TNF-a及IL-6含量正常，与A，B，C，D，E各实验组比较有统计学意义（P＜0.01）。3.腹腔清洗术后第3天，A，B，C，D四组TNF-α及IL-6值均有所下降，其中以1:5稀释络合碘组下降明显，A，B，C，D四组术后第1天与3天前后比较有差异性(P＜0.05)，其中B，C两组有非常显著性差异（P＜0.01㖞，E组术后第3天TNF-α及IL-6稍有上升，与各实验组比较有差异性（P＜0.05或P＜0.01）。4.术后第10天，观察各组大鼠腹腔内粘连情况，A、D组两组腹腔内粘连以Ⅱ～Ⅲ级为主，B，C组以0～Ⅰ级为主，而E组可见大量粘连，并难与腹膜分离，粘连紧密，以Ⅲ～Ⅳ级为主。5.术后第10天，从盲肠与腹壁粘连组织中，CollagenⅠ免疫组化表达来看，A，D两组可见呈棕黄色阳性着色的细胞比较多，呈阳性表达； B，C两组在少部分盲肠黏膜层上皮细胞及炎性细胞胞浆内，可见呈淡黄色细胞，为较低水平的CollagenⅠ阳性表达，为弱阳性；模型组（E组）盲肠组织黏膜层上皮细胞及炎性细胞胞浆内，可见大量深棕色阳性细胞，为CollagenⅠ强阳性表达；F组未见阳性细胞表达。 结论： 使用1:5-1:10稀释的络合碘清洗大鼠腹膜炎腹腔，能减少术后的炎症反应并能减轻腹腔内粘连。
[Abstract]:Objective: to observe the therapeutic effect of complex iodine at different concentrations on intraperitoneal inflammation and intraperitoneal adhesion in rats with sepsis, and to provide experimental evidence for the prevention and treatment of intraperitoneal inflammation and adhesion by using complex iodine solution during operation. Method 1: 1. 84 Sprague-Dawley (SD) rats were fed in adaptive cage for one week. The rats were randomly divided into normal saline group (n = 10), normal saline group (n = 1), control group (n = 10), model group (n = 10), and sham operation group (n = 5). The animal model of cecal ligation and puncture (1cm) peritonitis in SD rats was established by ligating the seventh silk thread from the cecum to the blind end of the cecum, puncturing the cecum with 18 needle and extruding a little feces. The 96-hour survival rate of rats in each group was observed. Group F only opened the abdominal cavity and turned over the intestine. 3. After 24 hours of modeling, all the four groups were relieved of the cecal ligation obstruction and closed the caecum perforation, and the caecum ligation obstruction and the caecum leakage were only relieved in group E by using normal saline 1: 5 diluted iodide 1: 10 dilute iodide 1: 20 dilute iodide 1 20 dilution complex iodine to clean the abdominal cavity of E group. The expression of IL-6 TNF- 伪 in plasma was detected by Elisa on the 1st and 3rd day after abdominal cleaning in the six groups of rats. On the 3rd day after operation, all three rats were killed for pathological observation. On the 10th day after operation, all the rats in each group were killed. The degree of intraperitoneal adhesion was evaluated by Nair5 classification method. The pathological changes of adhesion tissue and the immunohistochemical expression of Collagen 鈪
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