限制性液体复苏孕兔失血性休克对肠道细菌移位的影响  

The effect of limited fluid resuscitation on bacterial translocation in pregnant rabbit with hemorrhagic shock

作　　者：陈莉[1] 龚时鹏[2] 罗炳德[1] 

机构地区：[1]南方医科大学公共卫生与热带医学学院,广州510515 [2]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》2009年第9期675-677,681,共4页Progress in Obstetrics and Gynecology

基　　金：2008年国家自然科学基金资助项目(No:30840089)

摘　　要：目的:探讨限制性液体复苏孕兔失血性休克对肠道细菌移位的影响。方法:建立孕兔失血性休克模型,对比研究不同液体复苏孕兔失血性休克时,休克各时期的失血量、输液输血量,同时比较肝和回肠系膜淋巴结的细菌移位及血液内毒素的变化。结果:(1)休克各期限制性输液组输液输血量及失血量均少于传统输液组,两组差异有显著的统计学意义(P<0.01);(2)比较各组肝和回肠系膜淋巴结菌落数及血浆内毒素,限制性输液组明显低于其它各组,组间相互比较,差异有显著的统计学意义(P<0.01);(3)外周血培养结果显示限制性输液组阳性最低,组间差异有显著的统计学意义(P<0.01)。结论:限制性输液复苏孕兔失血性休克能更好地保护肠黏膜屏障,减少细菌移位,有效地防止休克发展,不失为抢救孕产妇失血性休克较为理想的输液方法。Objective：To investigate the effect of limited fluid resuscitation on bacterial translocation in pregnant rabbit with hemorrhagic shock. Method：The model of hemorrhagic shock in pregnant rabbit was established. When the hemorrhagic shock of pregnant rabbit was resuscitated by adopting two different transfusion means, bacterial translocation at lymph nodes of liver and mesoileum,the change of endotoxin content in blood were compared and valued. At the same time, the volume of blood loss, blood and fluid transfusion at various periods of shock were also compared. Results： （ 1 ） In the group of limited fluid resuscitation, the volumes of blood loss ,fluid and blood transfusion at various phase of shock were the least, while those in the normal resuscitation group were the most. （2）Compared with other groups, the number of colonies at lymph nodes of liver and mesoileum in that group was obviously decreased. As to the content of endotoxin in plasma of all groups,the change was same. All the differences were significant （P〈0.01）. （3）The results fl＇om peripheral blood culture showed there were evidently difference among all three groups, and that in the group of limited fluid resuscitation was the lowest. Conclusion ： Limited fluid resuscitation can protect the barrier of intestinal mucosa better in the pregnant rabbit with hemorrhagic shock. It can also reduce bacterial translocation, prevent the development of shock effectively and is a kind of ideal transfusion means to treat the hereof-rhagic shock in pregnant women or puerperants.

关 键 词：限制性输液疗法 细菌移位 休克 出血性 内毒素类 孕兔 疾病模型 动物 

分 类 号：R714.252[医药卫生—妇产科学]