本文選題：膿毒血癥 + 腹腔內(nèi)感染　； 參考：《南華大學(xué)》2013年碩士論文

【摘要】：目的：觀察不同濃度絡(luò)合碘對膿毒癥模型中大鼠腹腔內(nèi)炎癥的治療作用及腹腔內(nèi)粘連的影響，為術(shù)中使用絡(luò)合碘液預(yù)防和治療腹腔內(nèi)炎癥與粘連提供實驗依據(jù)。 方法：1.將84只SD實驗大鼠適應(yīng)性分籠喂養(yǎng)一周，按隨機數(shù)字表隨機分為正常生理鹽水組（A），，1：5稀釋絡(luò)合碘組（B），1：10稀釋絡(luò)合碘組（C），1：20稀釋絡(luò)合碘組（D），模型組（E），假手術(shù)組（F）。2.A，B，C，D，E五組大鼠，以7號絲線結(jié)扎距盲腸盲端1cm處，用18號針頭刺穿盲腸，并擠出少許糞便，建立SD大鼠盲腸結(jié)扎穿孔術(shù)(Cecal ligation and puncture,CLP)腹膜炎動物模型，觀察各組96小時大鼠存活率，F(xiàn)組僅僅打開腹腔，翻動腸管。3.建模24h后，A，B，C，D四組均解除盲腸結(jié)扎梗阻，并關(guān)閉盲腸穿孔處，分別用生理鹽水，1:5稀釋絡(luò)合碘，1:10稀釋絡(luò)合碘，1:20稀釋絡(luò)合碘清洗腹腔，E組僅解除盲腸結(jié)扎梗阻及盲腸漏口關(guān)閉，六組大鼠在腹腔清洗術(shù)后第1天和術(shù)后第3天，取血ELISA檢測血漿中IL-6，TNFα表達(dá)；4.術(shù)后第3天，各組均處死3只大鼠取回腸末端組織及肝臟組織行病理觀察。5.術(shù)后第10天處死各組所有大鼠，參考Nair5級分類法評估大鼠腹腔粘連程度，取腹腔內(nèi)粘連組織HE染色觀察粘連組織病理變化及CollagenⅠ免疫組化表達(dá)。 結(jié)果：1.建模后96小時內(nèi)，A，B，C，D，E五組均出現(xiàn)有大鼠死亡，其中死亡率以E組最高，高達(dá)40%；B，C兩組死亡率較低，分別與各組比較有統(tǒng)計學(xué)意義（P＜0.05）。2.腹腔清洗術(shù)后第1天各組TNF-α及IL-6指標(biāo)均升高，其中模型組(E組)升高最顯著，與其他各實驗組比較有差異性具有統(tǒng)計學(xué)意義（P＜0.05）；F組TNF-a及IL-6含量正常，與A，B，C，D，E各實驗組比較有統(tǒng)計學(xué)意義（P＜0.01）。3.腹腔清洗術(shù)后第3天，A，B，C，D四組TNF-α及IL-6值均有所下降，其中以1:5稀釋絡(luò)合碘組下降明顯，A，B，C，D四組術(shù)后第1天與3天前后比較有差異性(P＜0.05)，其中B，C兩組有非常顯著性差異（P＜0.01㖞，E組術(shù)后第3天TNF-α及IL-6稍有上升，與各實驗組比較有差異性（P＜0.05或P＜0.01）。4.術(shù)后第10天，觀察各組大鼠腹腔內(nèi)粘連情況，A、D組兩組腹腔內(nèi)粘連以Ⅱ～Ⅲ級為主，B，C組以0～Ⅰ級為主，而E組可見大量粘連，并難與腹膜分離，粘連緊密，以Ⅲ～Ⅳ級為主。5.術(shù)后第10天，從盲腸與腹壁粘連組織中，CollagenⅠ免疫組化表達(dá)來看，A，D兩組可見呈棕黃色陽性著色的細(xì)胞比較多，呈陽性表達(dá)； B，C兩組在少部分盲腸黏膜層上皮細(xì)胞及炎性細(xì)胞胞漿內(nèi)，可見呈淡黃色細(xì)胞，為較低水平的CollagenⅠ陽性表達(dá)，為弱陽性；模型組（E組）盲腸組織黏膜層上皮細(xì)胞及炎性細(xì)胞胞漿內(nèi)，可見大量深棕色陽性細(xì)胞，為CollagenⅠ強陽性表達(dá)；F組未見陽性細(xì)胞表達(dá)。 結(jié)論： 使用1:5-1:10稀釋的絡(luò)合碘清洗大鼠腹膜炎腹腔，能減少術(shù)后的炎癥反應(yīng)并能減輕腹腔內(nèi)粘連。
[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- 偽 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

本文編號：2013583