Видовий склад та рівень обсіменіння мікроорганізмами перитонеального ексудату в ранній період після моделювання скелетної, черепно-мозкової та поєднаної травм

Abstract

У статті вивчено характер обсіменіння мікроорганізмами перитонеального ексудату після механічної травми різної локалізації. Моделювання скелетної, черепномозкової та поєднаної краніоскелетої травм супроводжується транслокацією мікрофлори з порожнини кишок у перитонеальний простір. Ця мікрофлора найбільш інтенсивно виражена при моделюванні поєднаної травми через 3 доби посттравматичного періоду, найменш – при моделюванні черепно-мозкової травми. Популяції кишкових паличок першими й у вищих конценраціях колонізують перитонеальний простір. Найвищий показник вираженості мікрофлори в усіх групах дослідних тварин характерний саме для E. сoli порівняно з іншими виділеними мікроорганізмами. Показники постійності виділення бактерій були найвищими у тварин з поєднаної травмою.

В статье изучен характер обсеменения микроорганизмами перитонеального экссудата после механической травмы различной локализации. Моделирование скелетной, черепно-мозговой и сочетанной краниоскелетой травм сопровождается транслокацией микрофлоры из полости кишечника в перитонеальное пространство. Эта микрофлора наиболее интенсивно выражена при моделировании сочетанной травмы через 3 суток посттравматического периода, наименее — при моделировании черепно-мозговой травмы. Популяции кишечных палочек первыми и в высших конценрации колонизируют перитонеальный пространство. Самый высокий показатель выраженности микрофлоры во всех группах подопытных животных характерен именно для E. сoli сравнению с другими выделенными микроорганизмами. Показатели постоянства выделения бактерий были самыми высокими у животных с сочетанной травмой.

Introduction. The actual problem of severe trauma is the development traumatic disease with the formation of multiple organ failure. In recent years, more attention is paid to the gastrointestinal tract as a source of septic complications and multiple organ failure. There are still not fully explored the frequency and extent of microbial contamination of tissues, as one of the ways of their endogenous infection due to the translocation of gut microorganisms in peritoneal space, developing the various types of mechanical injury. Objective: To find out the laws of violations of humoral immunity parameters and content of circulating immune complexes in the dynamics of the early period after skeletal, craniocerebral and combined injuries. Materials and methods. Experiments were performed on 104 nonlinear white rats weighing 180-200 g Rats were on a standard diet vivarium. They were injured in the conditions of thiopental sodium anesthesia (40 mg·kg-1 weight). The control group consisted of intact animals. In animals who survived after 1, 3 and 7 days post-traumatic period under thiopental sodium anesthesia (40 mg·kg-1 body weight) in compliance with the rules of aseptic sampling was conducted biological material. Samples were taken from the lateral parts of the abdomen by disposable swab and was carried microbiological studies peritoneal fluid. Results and discussion. Results of the researches showed that skeletal modeling, modeling of traumatic brain and combined cranioskeletal injuries are accompanied by the translocation of microflora from the gut cavity to the perytonealnryy space. This microflora is expressed most intensely at the simulating combined trauma, and it is expressed the slightest at the modeling brain injury. About this is evidenced by indicators of bacterial contamination of peritoneal fluid, occurrence and data permanence selection enterobacteria cultures in different groups. Populations of E. coli first and in higher kontsenratsiyah colonize the peritoneal space. The highest expressiveness of microflora in all groups of experimental animals is typical for E. coli compared to other isolated microorganisms. Indicators of the permanence selection bacteria were highest in animals with combined trauma. Almost all of them are sown bacteria as opposed to a group of animals with a brain injury where some samples were taken sterile. Obviously, the severity of injuries was related to the ability of members of microflora gastrointestinal tract pass through the mucous membrane of the microorganism in extra-interstitial areas, particularly in the peritoneal space. These results confirm the findings of other authors, which proved that the risk of enteral insufficiency syndrome proportional to the severity of the injury. We can assume that the increase in the permeability of the intestinal wall in condition injury with translocation of intestinal microflora is general biological phenomenon, which should be considered in terms of intensive therapy of traumatic disease. Conclusion. 1. Skeletal modeling, modeling of traumatic brain and combined cranio skeletal injuries are accompanied by the translocation of microflora from the gut cavity to the peritoneal space. This microflora is expressed most intensely at the simulating combined trauma after 3 days of the post-traumatic period, and it is expressed the slightest at the modeling brain injury. 2. Populations of E. coli first and in higher concentrations colonize the peritoneal space. The highest expressiveness of microflora in all groups of experimental animals is typical for E. coli compared to other isolated microorganisms. Indicators of the permanence selection bacteria were highest in animals with combined trauma.