摘要
目的研究静脉输注高氧液和高渗盐水对创伤性失血性休克（traumatichemorrhag-icshock，THS）兔生存时问和24、48、72h存活率的影响。方法采用Lamson’s法制作创伤性失血性休克兔模型。按照高氧液和高渗盐水两因素的有无，采用2×2析因设计，将4｜D只日本长耳大白兔分为4组（n=10）：生理盐水组（Ns组）、生理盐水高氧液组（NSO组）、高渗盐水组（HS组）、高渗高氧液组（HSO组），在限制复苏期给予不同干预，止血复苏期予以相同干预。于休克前（T3）、休克末（T3）、限制复苏期末（T3）、止血复苏期末（T4）各时间点采取动脉血3mL检测肿瘤坏死因子-a（tumornecrosisfactorMpha，TNF—d）、超氧化物歧化酶（superoxidedismutase，SOD）、丙二醛（malondialdehyde，MDA），各组动物死亡后或存活满72h后取左心、左肺、小肠组织观察病理变化，同时观察各组兔子存活时间和24、48、72h存活率。结果HSO组存活时间高于其他各组，差异有统计学意义（P〈0．05），HSO组24、48、72h存活率高于其他各组，差异有统计学意义（P〈0．05）。兔创伤性失血性休克后血浆TNF-a水平较基础值升高，差异有统计学意义（P〈0．05），T3、Td时间点TNF-a水平下降，NSO、HS、HSO组TNF—a水平高于Ns组，差异有统计学意义（P〈0．05）。T2时间点，血浆SOD活性较T，时间点下降，差异有统计学意义（P〈0．05），L、T4时间点，各组血浆SOD活性继续下降，但NSO组、HS组、HSO组SOD活性高于Ns组，差异有统计学意义（P〈0．05）。各组兔血浆MDA浓度在T2时间点升高与T，时间点比较差异有统计学意义（P〈0．05），T3、T4时间点MDA浓度继续升高，但NSO组、HS组、HSO组MDA浓度低于Ns组，差异有统计学意义（P〈0．05）。NS组心、肾、小肠病理损伤高于NSO组、HS组和HSO组。结论静脉输注高渗盐水高氧液能延长创伤性失血性�
d Objective To study the influence of intravenous hyperoxia solution and hypertonic saline resuscitation on the survival time, 24 h, 48 h, and 72 h survival rates in rabbits with traumatic hemorrhagic shock （THS）. Methods Forty rabbits were established into THS model by Lamson＇s meth- od. Factorial design was adopted in trial according to hyperoxia solution and hypertonic saline existing or not divided the rabbits into four groups（n = 10） ： NS group, NSO group, HS group, HSO group. Differ- ent interventions on limited resuscitation phase were performed respectively. Then blood samples were taken at pre - shock, post - shock, the end of limited resuscitation and hemostatic resuscitation to check Tumor necrosis factor alpha （TNF- or）, Superoxide dismutase （SOD）, Malondialdehyde （MDA）, and observed the survival time, 24 h, 48 h, 72 h the survival rates. Results The survival time of rabbits inthe HSO group was longer than the other groups（P 〈0.05）, the 24 h, 48 h, 72 h survival rates of rab- bits in HSO group was higher than the other groups （ P 〈 0.05）. At the end of THS, TNF - a was in- creased compared to base line（P 〈0.05）, at the end of limited resuscitation and hemostatic resuscita- tion stage, TNF - ot was decreased in each group, and in NSO group, HS group, HSO group TNF - ct are lower than NS group（P 〈0.05）. At the end of THS, SOD was decreased than base line, at the end of limited resuscitation and hemostatic resuscitation stage, SOD remain to decrease, but in NSO group, HS group, HSO group SOD are higher than NS group（P 〈0.05）. At the end of THS, MDA was increased compared to base line（P 〈0.05）, at the end of limited resuscitation and hemostatic resuscitation stage, MDA continue to increased in each group, but in NSO group, HS group, HSO group MDA are lower than NS group（P 〈0.05）. Histopathological analysis showed that the NS group showed more severe in- jury in the heart, lung and intestine after hemorrhagic shock than NSO group, I-IS grou
出处
《中国急救医学》
CAS
CSCD
北大核心
2013年第2期172-176,I0002,共6页
Chinese Journal of Critical Care Medicine
基金
徐州市社会发展基金资助项目
