Effect Of Early Abdominal Paracentesis Drainage On Intestinal Mucosal Barrier Injure And Intestinal Microcirculation Disturbances In Severe Acute Pancreatitis Rats

Objective:Severe acute pancreatitis(SAP)is a deadly disease which start with pancreatic injure and secondary to multiple organs dyfunction.In recent years,some studies found that pancreatitis associated ascites(PAAF)often appear in the early stages of SAP,which contains a variety of toxic substances,such an tumor necrosis factor,interleukin,bacteria and endotoxin.It can not only directly injure the abdominal organs,but also can be absorbed into the systemic circulation and cause system injury.Among them,the PAAF can damage the function of intestinal mucosa,and lead to the complications of multiple organ dysfunction syndrome in SAP.In this experiment,we establishment a model of severe acute pancreatitis rats with early abdominal paracentesis drainage,and explore the efficiency of abdominal paracentesis drainage in SAP rats with intestinal mucosal injure and intestinal microcirculation disturbances by test the level of TNF-?,IL-1?,DAO,D-lactate,TXA2,PGI2,T/P in serum and ascites,the intestinal mucosal blood flow perfusion and mesenteric microcirculation status in each groups.Methods:All SD rats of SPF level were randomly divided into three groups:sham operated group(n=24),SAP group(n=24)and APD group(n=24).All rats were not allowed to eating food in 12h before the operation and after the operation,but free to drinking.The model of SAP rats were established by retrograde injection of 5%sodium tautocholate into hepatopancreatic duct.We place a drainage tube in the abdominal cavity of SAP rats to establish the APD rats.The SHAM rats were only deal with laparotomy surgery and turn of the pancreas for 3-5 times.Blood and ascites were collected at 24 hours after operation in each groups,and stored in refrigerator for next test.Meanwhile,the intestinal tissue were fixed in 4%neutral formaldehyde buffer for next pathological examination.The intestinal mucosal blood flow perfusion and mesenteric microcirculation were measured at 24 hours after operation in each groups.Blood and ascites of TNF-?,IL-1?,DAO,D-lactate,TXA2,PGI2 were evaluated by ELISA method.Intestinal pathological changes was observed under light microscopy using HE dyeing.The ileum mucosal blood flow perfusion was tested by laser Doppler flowmeter and the mesenteric microcirculation was observed by intravital microscopy.Results:The histopathological results,and the level of TNF-?,IL-1?,DAO,D-lactate,TXA2,PGI2 and T/P in serum and ascites of SAP group and APD group are significantly higher than that in the SHAM group at 24 hour after operation;Compared with SAP group,the histopathological results,and the levels of TNF-a,IL-1p,DAO,D-lactate,TXA2,PGI2 and T/P in serum and ascites were significantly alleviated in APD group.The ileum mucosal blood flow perfusion and mesenteric microcirculation of SAP group and APD group are significantly deteriorated than that in the SHAM group at 24 hour after operation;Compared with SAP group,The ileum mucosal blood flow perfusion and mesenteric microcirculation were significantly improved than that in APD group.Conclusion:Early abdominal paracentesis drainage can effectively reduce the injury of intestinal mucosal barrier,and improve the intestinal microcirculation dysfunction in SAP rat.