The Effects On The Gut Barrier Injury In Severe Acute Pancreatitis By Thoracic Duct Drainage

Objective: Severe acute pancreatitis (SAP) is an acute severe illness often died from secondary infections or organ failure.Researches in recent years are multiple organ failure before the central organs and organ moving.The studies of SAP injury when the intestinal barrier mechanisms and intervention studies have become one of the current hot spots. At present, the function of the thoracic duct - lymph in severe burns, infected with toxic shock, two-hit, such as the role of attention, and think its can be used as intestinal bacteria, endotoxin translocation channel mesenteric lymphatic ligation blocked two MODS against rats have been reported, but there is no report for the SAP. treatmentTaken in this experiment by injecting retrograde cholangiopancreatography 5% sodium taurocholate into SAP rat model of combined injury of the intestinal barrier, and contrast neck line thoracic duct drainage after the serum amylase (AMY), lipase (LIP), plasma D - lactic acid, diamine oxidase (DAO), thoracic duct lymph drainage changes endotoxin. Designed to reveal the mechanism of intestinal barrier damage, to explore effective interventions, and to provide experimental basis for clinical treatment. . Methods: 96 healthy SD rats, weighing 330±30g, were randomly divided into 12 groups of eight, including: neck sham-operated group + abdominal sham-operated group (SO1) 2, 6, 12 hours groups; cervical thoracic duct drainage + abdominal sham-operated group (SO2) 2, 6, 12 hours groups; neck sham + SAP group (SAP ) 2, 6, 12 hours groups; cervical thoracic duct drainage + SAP Group (TD) 2,6,12 hours (TD 2h, 26h, 12h) group;Retrograde cholangiopancreatography used by the injection of 5% sodium taurocholate SAP combined rat model of intestinal barrier damage, and set up channels via the tail vein infusion, the treatment group cervical thoracic duct drainage. Carried out by setting defacto pancreas, intestine and large observation and measurement of ascites volume, collecting blood, thoracic duct lymph drainage and tissue samples. Determination of the pancreas, small intestine pathology score. Serum AMY, LIP; plasma D-lactate, diamine oxidase (DAO) and the lymph drainage of the content of endotoxin.were testedResults:1.SO1 group compared with the SO2 amount of ascites, the pathological changes of pancreas and small intestine, D-lactate, diamine oxidase level are no significant difference(P<0.01).2.There are plenty of ascites in SAP groups but no in SO1 and SO2 groups ; There are an obvious congestive edema, patchy hemorrhage and black necrosis, scattered spots in the saponification in pancreas ..Ileum wall of the defacto group of dull, thickened, congestion and edema, and mucosal erosion to varying degrees and within the congestion mesocaval. There are some saponification intestinal scattered around the spot. The level of the Serum AMY, LIP is significantly higher ;pancreas pathology score was significantly higher.3.Comparee with SO2 groups,the level of endotoxin of the lymph drainage in TD groups increased, and significantly with time(P<0.01);4. Comparee with SAP groups, the level of the plasma D-lactate, diamine oxidase (DAO) in TD groups were increased with time obvious(P<0.01).5. Comparee with SAP groups the corresponding point in time, the pancreas hyperemia, edema, hemorrhage and significantly reduce necrosis, the saponification also markedly reduced plaque; ileal hyperemia, edema, hemorrhage decreased. And the level of AMY,LIP in blood significantly reduced intestinal villus height, mucosal thickness increased significantly; the level of the plasma D-lactate, diamine oxidase (DAO) are decreased.(P<0.01);Conclusions:1 Injecting with retrograde cholangiopancreatography 5% sodium taurocholate to be SAP model of combined injury of the intestinal barrier and up the neck on the basis of thoracic duct drainage in rats, the experimental method is stable and good repeatability.2 In SAP groups,there were changes of the mucosal injury of the pathological dull wall, thickening, congestion and edema, and mucosal erosion to varying degrees and within mesocaval congestion, intestinal saponification plaques scattered around; plasma D-lactate, diamine oxidase enzyme (DAO) levels, lymph drainage, endotoxin significantly increased, and increase with time on SAP when the intestinal barrier injury exist.3. After thoracic duct drainage the intestinal injury of the pathological changes in SAP groups was significantly reduced, the level of plasma D-lactate, diamine oxidase (DAO) were reduced.It means that the thoracic duct drainage play the on the protective role of intestinal barrier.