Clinical Study Of Bacteria Translocation In Patients With Intestinal Obstruction

Objective:To study the bacterial translocation (BT) incidence and common genus in patients with the intestinal obstruction. To observe the intestinal mucosal morphology changing in the intestinal obstruction status. To explore the relationship between the bacterial translocation and postoperative infection.Methods:84patients with surgery from June2009to July2011were divided into two groups.42cases with mechanical small bowel obstruction (SBO) is the study group.42cases of which staffed with other diseases are designed as the control group. At the start of the surgery a lymph node was excised from the mesentery of the terminal ileum. The sample was contained in sterile saline and sent for microbiological analysis to explore the rate of BT and the commonly bacteria. A SIRS score according to the postoperative body temperature, pulse, breathing and white blood cells was accumulated and the operative infective complication was monitored to explore the relation between BT and infection occurrence. Some bowels with obstruction were staining to observe the mucosal morphological changes.Results:The BT rate in SBO patients is higher than the compared patients (57%vs16.7%). Escherichia Coil is the most commonly bacteria. Staphylococcus aurous is a common non-intestinal translocation of bacteria. The BT Genus between the two groups were no significant differences (P>0.05). The rate of postoperative infection in study group is higher than the control group. There was no significant differences in the postoperative infection between the study group and the control group (P>0.05). but there was significant differences in the postoperative infection between the BT group and NO BT group (P<0.01). Structural disorder and glands reducing of the proximal small intestinal mucosal cells was seen under the light microscope. Intestinal mucosa microvillus and tight junction was seen broken under electron microscope.Conclusion:Mechanical small bowel obstruction increase the rate of BT. BT is a risk factor accounting for the postoperative infection. The integrity of the intestinal mucosa damaged in the mechanical small bowel obstruction may play a key role for the high BT rate.