辅助腹腔复苏对休克大鼠肠系膜淋巴活性的影响  

Effects of adjunct intraperitoneal resuscitation on bioactivity of mesenteric lymph in shock rats

作　　者：王新友[1] 李荣[1] 徐迎新[1] 

机构地区：[1]北京解放军总医院普通外科研究所,100853

出　　处：《解放军医学杂志》2009年第11期1318-1320,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨辅助腹腔复苏(IR)对失血性休克(HS)大鼠肠系膜淋巴活性的影响。方法采用股动脉放血法制作HS大鼠模型,在HS或假休克(SS)后60min行传统方法(CR)或CR联合辅助腹腔复苏(CR+IR)。实验大鼠分为6组:①SS组(n=4),②SS+CR组(n=4),③SS+CR+IR组(n=4),④HS组(n=4),⑤HS+CR组(n=5),⑥HS+CR+IR组(n=5)。所有HS大鼠的平均动脉压(MAP)控制在40mmHg,SS大鼠仅行动脉插管不放血,CR处理时静脉给予乳酸林格液(80ml/kg),IR处理时在CR的基础上同时腹腔注射腹膜透析液20ml/只。复苏后2h剖腹收集肠系膜淋巴液,测定与淋巴液共培养后的中性粒细胞呼吸爆发活性。实验结束时处死大鼠,取回肠组织,光镜下观察肠黏膜绒毛形态,评价肠黏膜损伤程度。结果HS组肠系膜淋巴活性显著高于SS组。与CR处理比较,CR+IR能显著抑制休克肠系膜淋巴介导的中性粒细胞的呼吸爆发作用(P<0.05),降低休克淋巴的活性水平。HS组肠黏膜绒毛顶端损伤增多,与SS组比较差异显著(P<0.01);与CR处理相比,CR+IR能明显减轻肠黏膜绒毛的损伤(P<0.01)。结论在CR基础上进行IR能有效保护肠道屏障的完整性,降低休克后肠系膜淋巴活性。Objective To explore the effect of adjunct intraperitoneal resuscitation （IR） on bioactivity of mesenteric lymph in hemorrhagic shock （HS） rats. Method The rat model of HS was reproduced by bleeding the rats from femoral artery. The rats were resuscitated by conventional resuscitation （CR） or CR plus adjunct IR 60 minutes after HS or sham shock （SS）.The rats were then divided into six groups as follows：SS group （n=4）,SS＋CR group （n=4）,SS＋CR＋IR group （n=4）,HS group （n=4）,HS＋CR group （n=5） and HS＋CR＋IR group （n=5）. The mean arterial pressure （MAP） of rats in HS group was maintained at 40mmHg without resuscitation. The rats in SS group underwent only artery cannulation without blood letting for pressure monitoring. The rats were resuscitated with Ringer＇s lactate （80ml/kg） in CR. When treated with IR,each rat was given peritoneal injection of 20ml peritoneal dialysis solution after CR. Two hours after resuscitation,mesenteric lymph was collected by laparotomy for the measurement of neutrophil respiratory burst activity after being incubated with lymph. At the end of experiment,rats were sacrificed,the intestinal tissues were collected and the ileum mucosal injury was evaluated by light microscopy. Results The bioactivity of lymph of HS group was significantly higher than that of SS group. Compared with CR,CR＋IR could inhibit shock lymph-mediated respiratory burst of neutrophils and attenuate the bioactivity of shock lymph significantly （P0.05）. Compared with SS group,more serious mucosal injury was found in HS group （P0.05）,and CR＋IR could attenuate the injury effectively compared with CR treatment （P0.01）. Conclusion Based on CR,IR can protect the integrity of gut barrier and depress the bioactivity of shock lymph.

关 键 词：休克 出血性 肠系膜淋巴 中性粒细胞 呼吸爆发 液体复苏 

分 类 号：R605.971[医药卫生—急诊医学]