Yanık sonrası oluşan barsak mukoza değişiklikleri ve bakteriyal translokasyona pentoksifillinin etkisi

Amaç: Yanık sonrasında ortaya çıkan barsak istemisinin neden olduğu akut enflamasyon mukoza hasarına ve bakteriyel translokasyona (BT) neden olmaktadır. Pentoksifillin (PTF) mikrovasküler sirkülasyonu düzenleyen ve antienflematuar etkileri olan bir ajandır. Bu çalışmada yanık sonrası ortaya çıkan barsak mukoza değişiklikleri ile buna eşlik eden BT'na PTF'nin etkisi araştırıldı. Yöntem: Wistar-Albino cinsi erişkin kırk sıçan 4 gruba ayrıldı. Deneklerin sırt cildi vücut yüzeyinin % 35'i oranında traş edilerek sıcak su ile üçüncü derece yanık oluşturuldu. Grup A konrol, grup B yanık grubu olarak belirlendi. C grubunda bulunan deneklere yanık oluşturulduktan 30 dk. sonra, D grubundakilere ise 4 saat sonra PTF verildi. Tüm gruplarda steril şartlar altında laparotomi yapılarak mikrobiyolojik çalışma için barsak, mezenter lenf nodu (MLN), dalak ve kandan, histopatolojik çalışma için ileumdan örnekler alındı. Bulgular: A grubunda kanda üreme olmazken MLN'da iki, dalakta bir, barsakta ise sekiz denekte üreme vardı. B grubundaki tüm deneklerden alınan örneklerde üreme saptandı, C grubunda bir denekte kanda, diğer örneklerde ise tüm deneklerde üreme tespit edildi. D grubunda kanda üreme olmadı, iki denekte MLN, üç denekte dalak, sekiz denekte barsakta üreme saptandı. Histopatolojik değerlendirmede; B grubunda normal mukoza villüs yapısına hiç rastlanmazken, C grubunda iki, D grubunda sekiz hayvanda normal mukoza villüs yapısı saptandı. Sonuç: Bu çalışmanın sonuçları yanık sonrası ortaya çıkan barsak mukoza hasarı ve bakteriyel translokasyonun. PTF tedavisi ile anlamlı şekilde azaldığını göstermektedir.

The effect of pentoxyfiline on the bacterial translocation and intestinalmucosal changes following burns

Aim: Intestinal ischemia occuring following burns causes acute inflamation, which in turn causes mucosal injury and bacterial translocation (BT). Pentoxyfilline (PTF) is an agent which regulates microvascular circulation and has antiinflanimatory effects. In this study, intestinal mucosal changes after burn and accompanying BT and the effect of PTF on BT is investigated. Method: Forty Wistar-Albino rats were randomly assigned to. f our groups. The backs of animals were shaved which consisted of % 35 of body surface area and and a third degree scald burn was formed. Group A was assigned as control and group B as burn group. PTF was administrated in group C at 30 minutes and in group D 4 hours after the burn. Under aseptic conditions, laparotomy was performed at 24 hours after burn in all groups and a segment of small intestine, mesenter lymph node (MLN), spleen and blood were removed for microbiologic analysis and ileum was taken for histopathologic study. Results: In group A blood cultures were sterile while there was growth in the MLN of two subjects, in the spleen of one subject and in the small intestine of eight subjects. Bacterial growth was identified in all samples in group B. In group C, bacteria were identified in blood of. one subject and in the other samples of the all subjects. In group D, blood cultures were sterile while there was growth in the MLN of two subjects, in the spleen of three subjects and in small intestine of eight subjects. Among the histopathologic evaluation, group B mucosal villi were all abnormal, while they were normal in two animals in group C and eight animals in group D. Conclusion: The result of this study demonstrates that intestinal mucosal injury and BT occuring after burn significantly decrease with PTF administration.

Kaynakça

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