限制性液体复苏孕兔失血性休克对肝功能的影响  

Effect of limited fluid resuscitation on hepatic function in pregnant rabbit with hemorrhagic shock

作　　者：龚时鹏[1] 余艳红[1] 陈莉[1] 

机构地区：[1]南方医科大学南方医院妇产科,广州510515

出　　处：《现代妇产科进展》2007年第3期191-193,F0003,共4页Progress in Obstetrics and Gynecology

基　　金：广东省重大社会问题联合攻关项目基金资助(No:ZKB04701S)

摘　　要：目的:探讨限制性液体复苏孕兔失血性休克对肝功能的影响。方法:制备孕兔失血性休克模型,采取两种不同输液方法使失血性休克孕兔复苏,对比各组各时间点ALT的变化,观察处死后孕兔肝脏病理检查结果。结果:孕兔失血性休克后血清ALT增高,导致肝细胞功能损害;复苏后限制性输液(PLH组)和传统输液(PNL组)的ALT随着输液抢救逐步下降;在孕兔失血性休克模型的90、180、240min时,比较PLH组与PNL组血清ALT,见PLH组的ALT下降明显,两组有极显著差异(P<0.01),PLH组在4h时ALT值已达到正常水平。病理检查表明,假休克组的肝脏未发生明显的病理改变;休克未处理组肝脏结构破坏,充血肿胀、坏死;限制性输液组肝脏组织结构正常,有少量炎性细胞浸润;传统输液组肝脏结构基本正常,部分组织充血,大量炎性细胞浸润。结论:限制性输液能有效地保护肝细胞功能,减低谷丙转氨酶,减少肝脏病理损害,是抢救孕兔失血性休克的理想复苏方法。Objective：To investigate the effect of limited fluid resuscitation on hepatic function in pregnant rabbits with hemorrhagic shock. Methods ：The model of hemorrhagic shock in pregnant rabbits was established. The hemorrhagic shock of pregnant rabbit was resuscitated by adopting different transfusion approach. The ALT change at various time points and pathological change in the liver were compared between the different groups. Results： The pregnant rabbit with hemorrhagic shock could cause the damage of hepatic function, resulting in the elevation of ALT. The ALT decreased gradually following salvaged transfuse in PLH group and PNL group. At 90,180,240minutes, the ALT was significantly different （P 〈 0. 01 ） between limited fluid group and tradition fluid group. At 4 hours of the model,the ALT was normal in limited fluid group. The results from pathological examination indicated no obvious pathological change in the liver of pseud-shock group. In the untreated group,bepatic structure was destroyed,hyalinization and necrosis of hepatic organization could be detected. In the limited fluid group,a few inflammatory cells could be seen in the hepatic organization,its hepatic structmre was normal. In the tradition fluid group,a few inflammatory cells could be seen in the liver,its hepatic structure was normal,but a great deal of inflammatory cells infiltrated around hepatic organization. Conclusion：Limited fluid resuscitation can distinctly protect the hepatocyte function of pregnant rabbits is an ideal resuscitation approach for the hemorhagic shock in pregnant rabbits.

关 键 词：限制性输液 丙氨酸转氨酶 休克 出血性 病理学 兔 

分 类 号：R575.3[医药卫生—消化系统]