摘要
目的探讨丙戊酸钠对重度烧冲复合伤休克延迟补液大鼠内脏组织灌流和生存率的影响。方法共360只雄性SD大鼠,(1)实验一,选择300只大鼠,按照随机数字表法分为假伤+延迟补液组(SD组,n=50)、假伤+丙戊酸钠+延迟补液组(SPD组,n=50)、烧冲复合伤+延迟补液组(BD组,n=100)、烧冲复合伤+丙戊酸钠+延迟补液组(BPD组,n=100)。SD组和SPD组大鼠37℃水浴浸泡背部12 s,腹部6 s;BD组和BPD组先用5 g高爆炸药距离大鼠50 cm爆炸致中度冲击伤,然后立即94℃沸水浸泡背部12 s,腹部6 s,致50%总体表面积Ⅲ度烧伤;SPD组和BPD组伤后即刻皮下注射丙戊酸钠(300 mg/kg)。SD组、SPD组、BPD组和BD组于伤后6、24 h分别按照Parkland公式腹腔内注射0.9%氯化钠溶液进行补液。于伤后即刻,伤后6、24、48、72 h 5个时间点,每个时间点均从SD组、SPD组、BD组、BPD组选择10、10、20、20只大鼠进行各脏器血流量和血气分析。(2)实验二,选取剩余的60只大鼠,按随机数字表法也分为SD组(n=10)、SPD组(n=10)、BD组(n=20)、BPD组(n=20)。于造模前48 h进行颈动脉置管。各组大鼠造模、处理同实验一操作。于伤后即刻,伤后6、24、48、72 h 5个时间点,检测各组大鼠平均动脉压(MAP),同时计算各组大鼠生存率。数据比较采用单因素方差分析、t检验、log-rank检验和χ~2检验。结果实验一结果显示:(1)伤后即刻,4组肝脏、肾脏和小肠黏膜血流量比较,差异均无统计学意义(P值均大于0.05);伤后6 h,4组肝脏、肾脏和小肠黏膜血流量组间总体比较,差异均有统计学意义(F=463.45、267.27、449.64,P值均小于0.05),BPD组与BD组肝脏、肾脏和小肠黏膜血流量比较,差异均无统计学意义(P值均大于0.05);伤后24 h,4组肝脏、肾脏和小肠黏膜血流量组间总体比较,差异均有统计学意义(F=1347.52、125.23、1210.84,P值均小于0.05),BPD组与BD组肝脏、肾脏和小肠黏膜血流量比较,差异均有统计学意义
Objective To investigate the effects of sodium valproate on visceral tissue perfusion and survival rate of abdominal organs in rats with delayed fluid resuscitation after severe burn-blast combined injury.Methods A total of 360 male SD rats,(1)Experiment one,300 rats were selected and divided into sham injury+delayed fluid resuscitation group(SD group,n=50),sham injury+sodium valproate+delayed fluid resuscitation group(SPD group,n=50),burn-rush combined injury+delayed fluid resuscitation group(BD group,n=100)and burn-rush combined injury+sodium valproate+delayed fluid resuscitation group(BPD group,n=100)according to the random number table method.The SD group and SPD group were soaked the back of rats in the 37℃water for 12 s and the abdomen for 6 s.The BD group and BPD group were blasted with 5 g high explosive at a distance of 50 cm from the rat to cause moderate impact injury,and then immediately immersed the back of rats in boiling water at 94℃for 12 s,abdominal for 6 s,causing 50%total body surface area of full thickness burns.SPD group and BPD group were injected subcutaneously with sodium valproate(300 mg/kg)immediately after injury.SD group,SPD group,BPD group and BD group were injected intraperitoneally with 0.9%sodium chloride solution according to the Parkland formula at 6,24 h after injury for rehydration.Immediately after the injury,6,24,48,72 h after injury,each time point 10,10,20,20 rats were selected from the SD group,SPD group,BD group,BPD group for visceral blood flow and blood gas analysis.(2)Experiment two,the rest of the 60 rats were divided into 4 groups according to the random number table method:SD group(n=10),SPD group(n=10),BD group(n=20)and BPD group(n=20).The modeling and treatment of the rats in each group was the same as experiment one.Carotid arteries were placed in all rats 48 h before modeling.The mean arterial pressure(MAP)of rats in each group was measured at 5 time points immediately after injury and at 6,24,48,72 h after injury,and the survival rate of each group was also
作者
吴育寿
岳晓彤
柴家科
畅阳
刘玲英
刘伟
韩绍芳
王晓腾
胡森
Wu Yushou;Yue Xiaotong;Chai Jiake;Chang Yang;Liu Lingying;Liu Wei;Han Shaofang;Wang Xiaoteng;Hu Sen(Department of Graduate,Medical School of Chinese PLA,Beijing 100853,China;Burn Institute,Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Research Center of Trauma Repair and Tissue Regeneration,Medical Innovation Research Department,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2020年第1期10-17,共8页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
军委后勤保障部重大项目(AWS15J003,ALB19J001)
国家自然科学基金面上项目(81471872,81571894,81772067)
关键词
烧伤
丙戊酸
大鼠
灌流
休克
存活率
冲击伤
血流量
Burns
Valproic acid
Rats
Perfusion
Shock
Survival rate
Blast injury
Blood flow
