限制与积极液体复苏对未控制的出血性休克大鼠肠黏膜机械屏障的影响  

Effects of limited fluid resuscitation and aggressive fluid resuscitation on Intestinal Epithelium Mechanical Barrier In rats with uncontrolled hemorrhagic shock

作　　者：刘晓亮[1] 张兴文[1] 刘智玲[1] 周玉成[1] 

机构地区：[1]湖南省人民医院急诊科,湖南长沙410005

出　　处：《创伤与急诊电子杂志》2013年第2期17-20,共4页Journal of Trauma and Emergency(Electronic Version)

基　　金：湖南省科技厅2010年度科研计划项目(编号:2010FJ3028)

摘　　要：目的研究限制性和积极性液体复苏对未控制的出血性休克(uncontrolled hemorrhagic shock,UHS)大鼠肠黏膜机械屏障功能障碍的影响。方法 36只SD大鼠建立UHS模型,随机分成对照组(A组)、限制性复苏组(B组)、积极复苏组(C组)。模拟创伤救治过程,A组大鼠未行液体复苏,B、C组进行不同方法液体复苏,5小时后观察各组进行小肠组织病理学改变和电镜超微结构。结果 A组病理学评分高于B、C组,B组低于C组(P<0.05),电镜下肠黏膜观察:B组大鼠肠上皮细胞、微绒毛、线粒体、细胞核等受损程度较C组轻。结论 UHS出现严重肠黏膜机械屏障破坏,限制性液体复苏较快速积极复苏更能减轻实验性UHS大鼠肠黏膜的病理损伤,可能对UHS大鼠肠黏膜机械屏障保护更有益。Objective To study the effects of limited fluid resuscitation and aggressive fluid resuscitation on intestinal epithelium mechanical barrier dysfunction in rats with uncontrolled hemorrhagic shock. Method models of 36 sd rats with uncontrolled hemorrhagic shock were installed and divided randomly into 3 groups:(a)control group,(B) limited fluid resuscitation group,(c) aggressive fluid resuscitation group.fluid resuscitation was not used in a group, while different measures of fluid resuscitation in B and c group, To evaluate histopathology scoring and observe ultrastructure of intestinal mucosal by electron microscope all of rats after 5h.Result The histopathology scoring of a group is higher significantly than B and c group. The damages of intestinal epithelium cells, microvilli, mitochondria, nuclear in B group were lighter than those in group c under observing electron microscope. Conclusion uHs lead to serious damages in intestinal epithelium mechanical barrier, there were few damages by applying the limited fluid resuscitation than that by aggressive fluid resuscitation, and it was benefical for intestinal Epithelium mechanical Barrier in rats with uHs.

关 键 词：限制性液体复苏 积极液体复苏 未控制的出血性休克 肠黏膜机械屏障 

分 类 号：R641[医药卫生—外科学]