[An experiment of gut barrier function damage following multiple firearm injuries in a porcine model].

OBJECTIVE: To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in porcine models.
METHODS: 24 small pigs were divided into 4 groups (n = 6 each): control group(group C), group H (gunshot-induced tangential fracture of parietal bone), group L (gunshot-induced comminuted fracture of bilateral femora) and group M (combined group H + L). Gastric intramucosal pH (pHi), plasma endotoxin in portal vein, and plasma D-lactic acid were measured and blood samples were cultured at different time intervals after trauma. The animals were sacrificed at 72 h and ileum tissues were harvested for pathological examination and DAO measurement. RESULT: In group M at 72 h, pHi was significantly lower than that of group H and L(P < 0.01), plasma endotoxin level was significantly higher than that of group H(P < 0.01) and group L(P < 0.05), D-lactic acid level was significantly higher than that of group H(P < 0.01), and bacterial isolation rate in blood was much higher than that of group H and L(P < 0.05). Necrosis and peeling off were revealed at ileum villus top in all trauma groups, especially in group M, in which ileum DAO content also declined in most cases.
CONCLUSION: Multiple traumas were prone to gastrointestinal ischemia even when hemorrhagic shock did not take place. The damage of gut barriers in multiple traumas were more severe than that in one-site trauma, which enhanced the incidence of intestinal endotoxin and bacterial translocation and trend to cause enterogenous infection.