颈交感神经阻滞对放烧复合伤小鼠死亡率的影响及其可能的作用途径(英文)  

Effect of cervical sympathetic ganglia block on the mortality of mice with combined radiation and burn injury and its possible mechanism

作　　者：陆建华[1] 施冲[1] 粟永萍[2] 程天民[2] 杜智勇[2] 

机构地区：[1]解放军广州军区广州总医院麻醉科,广东省广州市510010 [2]解放军第三军医大学军事预防医学院全军复合伤研究所,创伤烧伤复合伤国家重点实验室,重庆市400038

出　　处：《中国临床康复》2006年第34期177-180,共4页Chinese Journal of Clinical Rehabilitation

基　　金：国家"九七三"创伤项目01课题(G1999054201);海外青年学者合作研究基金项目(30328025);国家自然科学基金重点项目(30230360)~~

摘　　要：背景:颈交感神经阻滞促进机体神经-内分泌-免疫系统等稳态的恢复,其能否抑制创伤后应激紊乱导致的内稳态失衡仍不明确。目的:观察颈交感神经阻滞对放烧复合伤小鼠死亡率的影响,探讨颈交感神经阻滞可否成为严重创伤后续损害简单有效的治疗手段。设计:随机分组设计,动物对照实验。单位:解放军广州军区广州总医院麻醉科。材料:实验于2004-02/2005-07在解放军第三军医大学复合伤研究所完成。选择昆明小鼠160只,随机抽签法分为对照组80只(仅对动物给予放烧复合伤,颈部注射生理盐水0.3mL)和颈交感神经阻滞组80只(对动物给予放烧复合伤,伤后给予颈交感神经阻滞,1次/d,连续14d)。方法:动物致伤方法:①放射损伤:60Coγ射线5Gy,照射距离1.5m,吸收剂量率(5.17～5.33)mGy/s,全身一次均匀照射。②烧伤:放射损伤后给予20g/L凝固汽油涂于背部燃烧8s造成15%总体表面积Ⅲ度烧伤(病理切片证实)。颈交感神经阻滞方法:对大鼠进行双侧颈交感神经阻滞,注射5g/L利多卡因0.2mL,注射后5min观察小鼠是否出现类似于霍纳综合征症状。主要观察指标:观察两组动物伤后2,5,7,10,15,20,30d死亡率及伤后7,14,21d外周血红细胞、白细胞、血小板计数的变化,另观察颈交感神经阻滞对放烧复合伤后3,6,14d血清肿瘤坏死因子α、白细胞介素1β、白细胞介素6的影响。结果:纳入动物160只,均进入结果分析。①与对照组比较,颈交感神经阻滞治疗使放烧复合伤后5,7,10,15,20,30d的死亡率显著降低犤对照组各时相点累计死亡率分别为8%,22%,32%,54%,74%,82%,90%;颈交感神经阻滞组分别为8%,14%,16%,22%,28%,34%,56%犦。②颈交感神经阻滞组伤后7,14,21d的血红细胞计数、血小板计数及白细胞计数与对照组比较显著增加犤以21d为例,血红细胞计数分别为23.21×1012L-1,14.58×1012L-1;血小板计数分别为16.87×1011L-1,12.57×1011L-1;白细胞计�BACKGROUND： Cervical sympathetic ganglia block accelerates the recovery of the homeostasis of organic nervous-endocrine-immune system, but it is still unclear whether it can suppress the imbalance of homeostasis induced by post-traumatic stress disorder. OBJECTIVE： To observe the effect of cervical sympathetic ganglia block on the mortality of mice with combined radiation and burn injury, and whether it can become an easy and effective method to treat secondary damage after serious trauma. DESIGN： A randomized grouping design, an animal controlled experiment. SETTING： Department of Anesthesiology, Guangzhou General Hospital, Guangzhou Military Area Command of Chinese PLA. MATERIALS： The experiments were carried out in the Institute of Combined Injury, the Third Military Medical University of Chinese PLA between February 2004 and July 2005. Totally 160 Kunming mice were randomly divided into control group （n=50） and cervical sympathetic ganglia block group （n=50）. In the control group, the mice were only induced to models of combined radiation and bum injury, and treated with injection of 0.3 mL saline at cervical part. in the cervical sympathetic ganglia block group, the mice were induced to models of combined radiation and bum injury, and then treated with cervical sympathetic ganglia block, once a day for 14 days continuously. METHODS： Methods to induce injury in the animals： ① Radiation injury： The mice were given even radiation of ^60Coγ ray （5 Gy） at a distance of 1.5 m to the whole body, the rate of absorptive dosage was （5.17- 5.33） mGy/s. ② Burn injury： After the radiation injury, coagulated gasoline was smeared on the back and burnt for 8 s to induce degree In burn injury of 15% of the total body surface, which was proved by the pathological section. Methods of cervical sympathetic ganglia block： Cervical sympathetic ganglia block was given bilaterally, and then the mice were injected with 0.2 mL lidocaine （5 g/L）, and it was observed whether the symptoms simi

关 键 词：辐射损伤 烧伤 神经节 交感 颈 神经传导阻滞 

分 类 号：R644[医药卫生—外科学]