肠源性感染的实验研究

被引：34

作者：

马利

黎鳌

肖光夏

Edwin A Deitch

机构：

[1] 西南医院烧伤研究所

[2] 美国路易斯安娜州Shreveport医学院外科

来源：

第三军医大学学报 | 1990年 / 01期

关键词：

肠源性感染; 烧伤; 出血性休克; 内毒素血症; 蛋白质营养不良; 肠梗阻;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

感染仍然是外科危重病人的主要死因之一。30％以上死于感染和多脏器功能衰竭病人的感染病灶,即使在尸检时也从未明确。多数感染都是由G-杆菌、肠球菌以及白色念株菌这一类肠道常驻菌群所致。设想肠道可以是全身感染的感染源。细菌经由肠道通过肠粘膜侵入肠系膜淋巴结及体内其他脏器中的过程,国外称之谓“细菌的移居”,我们长期以来称之为“肠源性感染”。在外科临床上,休克、营养不良、内毒素血症及以肠道内容物郁滞为特征的肠麻痹等因素常常合并存在,这些因素对于临床的感染率和病死率有促进作用。为澄清它们与肠源性感染之间的关系,本实验选用950只无特殊致病动物及无菌动物,以细菌学研究为主,病理学观察为辅,结合生化和药理学方法;利用烧伤、出血性休克、内毒素血症、蛋白质营养不良及小肠梗阻等不同动物模型;从多个方面,不同层次,对创伤后早期阶段肠源性感染的发生、发展等方面进行了系统的研究。结果发现:烧伤后早期肠道内细菌可以侵入体内;一定时限的低血容量性休克能够造成肠源性感染;循环中的内毒素可以促进肠道中细菌的侵入;蛋白质营养不良对内毒素上述的致病作用具有协同作用以及单纯小肠梗阻后肠道内细菌可进行性地侵入体内;最终导致致死性的肠源性感染。实验证明,创伤后早期阶段,肠源性细

引用

页码：1 / 69

页数：69

共 12 条

[1] Gastrointestinal damage induced by platelet-activating factor[J] . John L. Wallace,Brendan J. R. Whittle.Digestive Diseases and Sciences . 1988 (2)
[2] THE GUT ORIGIN SEPTIC STATES IN BLUNT MULTIPLE TRAUMA (ISS = 40) IN THE ICU
BORDER, JR
HASSETT, J
LADUCA, J
SEIBEL, R
STEINBERG, S
MILLS, B
LOSI, P
BORDER, D
[J]. ANNALS OF SURGERY, 1987, 206 (04) : 427 - 448
[3] Inhibition of PAF-lnduced Systemic Responses in the Rat, Guinea Pig, Dog and Primate by the Receptor Antagonist SRI 63-441[J] . Thrombosis and Haemostasis . 1986 (01)
[4] Partitioning of paracellular conductance along the ileal crypt-villus axis: A hypothesis based on structural analysis with detailed consideration of tight junction structure-function relationships[J] . Manuel A. Marcial,Susan L. Carlson,James L. Madara.The Journal of Membrane Biology . 1984 (1)
[5] Induction of prostaglandin synthesis-dependent suppressor cells with endotoxin: Occurrence in patients with thermal injuries[J] . John L. Ninnemann,Alan E. Stockland,J. Thomas Condie.Journal of Clinical Immunology . 1983 (2)
[6] ENDOTOXAEMIA AND RENAL-FAILURE IN CIRRHOSIS AND OBSTRUCTIVE-JAUNDICE
WILKINSON, SP
MOODIE, H
STAMATAKIS, JD
KAKKAR, VV
WILLIAMS, R
[J]. BRITISH MEDICAL JOURNAL, 1976, 2 (6049) : 1415 - 1418
[7] STUDY OF RETICULOENDOTHELIAL PHAGOCYTIC CAPACITY IN PATIENTS WITH CHOLESTASIS
DRIVAS, G
JAMES, O
WARDLE, N
[J]. BRITISH MEDICAL JOURNAL, 1976, 1 (6025) : 1568 - 1569
[8] REDUCED SECRETORY ANTIBODY-RESPONSE TO LIVE ATTENUATED MEASLES AND POLIOVIRUS VACCINES IN MALNOURISHED CHILDREN
CHANDRA, RK
[J]. BRITISH MEDICAL JOURNAL, 1975, 2 (5971) : 583 - 585
[9] Colonization resistance of the digestive tract and the spread of bacteria to the lymphatic organs in mice[J] . D. van der Waaij,J. M. Berghuis-de Vries,J. E. C. Lekkerkerk-van der Wees.Journal of Hygiene . 1972 (2)
[10] Transmural Migration of Intestinal Bacteria During Peritoneal Irrigation in Uremic Dogs. ?[J] . Fritz B. Schweinburg,Howard A. Frank,Edward D. Frank,Felix Heimberg,Jacob Fine.Proceedings of the Society for Experimental Biolo . 1949 (1)

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