Farklı bakteriyel kontaminasyonun sıçanlarda deneysel adeziv barsak obstrüksiyonuna etkisi

Gökhan Demi̇rtaş, Doğuş Çalışkan, Pınar Celepli̇, Sema Hücümenoğlu, Tuğrul Ti̇ryaki̇
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Abstract

Aim: Postoperative peritoneal adhesions (PPA) cause pain, intestinal obstruction and infertility after abdominal surgery and to date there is no shown pathogenesis or definitive treatment. One of the most important points in intraabdominal interventions is bowel flora and its effect on infection. It was thought that different microorganisms found in flora or frequently added as hospital flora might cause inflammatory processes and cause PPA formation. There are a lot of studies showing intraabdominal infections cause PPA but there is no study comparing the effect of different bacterial strains on PPA formation. That is why we designed this study using the most common microorganisms isolated in intraabdominal infections and hospital flora. In this study, we aimed to investigate the effect of different bacterial strains (Klebsiella spp, E. coli spp, anaerobe) on the formation and degree of PPA in adhesion formation in rats. Methods: In this study, rats were divided into 5 groups, consisting of twelve rats. Groups were classified as; E. coli, Klebsiella, Bacteriodes fragilis, Sham and Control groups. The rats were sacrificed on the fourteenth day and relaparotomy was performed. The results were evaluated macroscopically and microscopically according to the previously determined classifications. Results: When bacterial infected groups were compared with sham and control groups, both microscopic and macroscopically significant increase in PPA was observed. Conclusion: In the experimentally generated adhesion model, microorganisms have been found to play an active role in PPA formation. But there was no significant difference between bacterial strains on PPA formation.
目的:术后腹膜粘连(PPA)引起腹部手术后疼痛、肠梗阻和不孕,迄今为止还没有明确的发病机制或明确的治疗方法。在腹腔内干预中最重要的一点是肠道菌群及其对感染的影响。人们认为,在菌群中发现的不同微生物或经常作为医院菌群添加的微生物可能引起炎症过程并导致PPA的形成。有很多研究表明腹腔内感染会引起PPA,但没有研究比较不同菌株对PPA形成的影响。这就是为什么我们设计了这项研究,使用从腹腔感染和医院菌群中分离出的最常见的微生物。本研究旨在探讨不同菌株(克雷伯氏菌、大肠杆菌、厌氧菌)对大鼠黏附形成中PPA的形成及程度的影响。方法:将大鼠分为5组,每组12只。分组分为;大肠杆菌,克雷伯氏菌,脆弱杆菌,假手术组和对照组。第14天处死大鼠,开腹手术。根据先前确定的分类对结果进行宏观和微观评价。结果:与假手术组和对照组比较,细菌感染组在显微镜下和宏观上均观察到明显的PPA升高。结论:在实验建立的黏附模型中,发现微生物在PPA的形成中发挥了积极的作用。但菌株间PPA的形成无显著差异。
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