【作者】 杨明三；

【导师】 段绍斌；

【作者基本信息】 新疆医科大学 ， 中西医结合临床， 2009， 硕士

【摘要】 目的:研究失血性休克不同液体复苏再二次打击致多脏器功能障碍综合征(MODS)时血管内皮细胞(EC)损伤影响。方法: SD大鼠84只,随机分为正常对照组、生理盐水复苏组、7.5%高渗盐水复苏组、万汶复苏组4组,每组21只。除正常对照组腹腔注入等量生理盐水外,其余3组SD大鼠失血性休克维持1h,进行不同液体复苏,复苏成功30min后3组腹腔注射内毒素。分别在注射内毒素后24、48、72h四组随机取7只大老鼠抽取静脉血检测各组EC生化指标循环内皮细胞(CEC)、一氧化氮(NO)、内皮素(ET-1)。结果:复苏再二次内毒素打击致MODS中,CEC数量生理盐水复苏组最高,对照组最低(P<0.05),7.5%高渗复苏组明显低于生理盐水复苏组(P<0.05)。NO含量以7.5%高渗复苏组最高,并随时间延长数量逐渐增加,高于生理盐水复苏组及万汶复苏组(P<0.05)。ET-1含量7.5%高渗复苏组低于生理盐水复苏组及万汶复苏组(P<0.05)。各检测指标随时间变化无明显改变(P>0.05)。镜下观察7.5%高渗盐水复苏组脏器标本切片病理改变比生理盐水复苏组轻。结论:失血性休克不同复苏液体内毒素二次打击致MODS血管内皮细胞损伤程度不同,7.5%高渗盐水复苏具有抗血管内皮细胞损伤作用。同时能够减轻重要脏器损伤,改善MODS预后。更多还原

【Abstract】 Objective: To study the influence of blood vessel endothelium cell of MODS rats which resuscitated hemorrhagic shock by different liquid and strike with the endotoxin again. Methods:84 SD rats were randomly divided into four average groups(n=21)which named Normal conrol group, Resuscitated by 0.9% normal saline group, Resuscitated 7.5% hypertonic saline group and Resuscitated by Hydroxyethyl Starch (130/0.4) group。Beside Normal conrol group abdominal cavity pours into 0.9% normal saline(2ml/100g), the other three group of SD rats all had been kept hemorrhagic shock for one hour, then resuscitated by different liquid.and after 30 minutes during accomplish anabiosis , the three groups rats were injected into antrum of abdomen with the endotoxin again. After it the blood of vein which was taken out from different 7 rats got randomly from the four groups on 24、48、72h was tested about the level of CEC、NO、ET-1. Results: Of the MODS rats which resuscitated hemorrhagic shock by different liquid and strike with the endotoxin again , the CEC quantity of Resuscitated by 0.9% normal saline group is the highest and the control group the lowest (P <0.05). the CEC quantity of 7.5% hypertonic saline group is lower than Resuscitated by 0.9% normal saline group (P <0.05 ).The content of NO to 7.5% hypertonic resuscitation group is the highest with time a gradual increase in quantity, and is higher than Resuscitated by 0.9% normal saline group, and Resuscitated by Hydroxyethyl Starch (130/0.4) group (P <0.05) The ET-1 content of 7.5% hypertonic saline group is lower than the Resuscitated by 0.9% normal saline group and Resuscitated by Hydroxyethyl Starch (130/0.4) group (P <0.05) .Detect the target over time no significant change (P> 0.05).Endoscopic observation,pathological changes of the heart,liver,kidney of the recovery of 7.5% hypertonic saline group is lighter than the normal saline resuscitation group . Conclusions: It is different the influence of blood vessel endothelium cell of rats model which resuscitated hemorrhagic shock by different liquid and strike with the endotoxin again. 7.5% hypertonic saline resuscitation has anti-vascular endothelial cell injury,at same time to reduce important organ damage and improve the prognosis of MODS.更多还原