饲菌复合低血容量性休克诱发兔肠源性脓毒症和多脏器功能失常综合征的实验研究  

Feeding E.coli plus severe hypovolemic shock induces gut origin sepsis and multiple organ dysfunction syndrome in rabbits

作　　者：胡森[1] 盛志勇[1] 梁延杰[1] 薛立波 姚咏明[1] 陆江阳[1] 黎君友[1] 祝小枫[1] 晋桦[1] 

机构地区：[1]解放军第三○四医院烧伤研究所

出　　处：《中国危重病急救医学》1998年第10期587-591,共5页Chinese Critical Care Medicine

基　　金：军队"八五"攻关课题基金

摘　　要：目的：复制一种创伤后肠源性脓毒症和多脏器功能失常综合征（ＭＯＤＳ）动物模型。方法：家兔饲入大肠杆菌（Ｏ１１１Ｂ４）１．５×１０１１个／ｋｇ后，造成低血容量性休克〔平均动脉压为５．３ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ），维持１小时〕和再灌注损伤，术后静脉输入５％葡萄糖生理盐水５０ｍｌ·ｋｇ－１／ｄ，实验观察１４日。另设５个对照组，分别观察手术、饲菌、休克、复苏和内毒素对器官功能的影响。结果：实验组动物休克复苏后１日～３日出现肠源性菌血症和内毒素血症，随后表现出全身炎症反应、高血糖和氨基酸代谢障碍。实验组动物死亡率和ＭＯＤＳ发生率分别为８８．３％和７１．６％。病理学观察显示，肝、肾、肺和小肠多脏器实质性损害。结论：本模型模拟了创伤后ＭＯＤＳ的常见诱因和临床特征，ＭＯＤＳ发病率高达７０％以上。Objective:To replicate an animal model of gut origin sepsis and multiple organ dysfunction syndrome (MODS) following severe trauma and shock.Methods:One hundred and fifty white rabbits were randomized into 6 groups.Animals in test (T) group were fed live E.coli (1 5×10 11 /kg),followed by hypovolemic shock 5 3 kPa (1 kPa=7 5 mmHg) mean arterial pressure for an hour plus rapid resuscitation with shed blood and Ringer solution.Five groups served as controls:sham operation,feeding live E.coli only,shock with resuscitation,shock without resuscitation,and feeding dead E.coli.Results:After hemorrhage and resuscitation,animal in group T had gut origin bacteremia and endotoxemia within 1￣3 days,and progressively developed systemic inflammatory response,hyperglycemia and significant changes in plasma free amino acids.In group T the incidence of MODS was 71 6% and mortality rate was 88 3%.Conclusions:This animal model can fully replicate the risk factors and clinical features of gut origin sepsis and rapidsingle phrase MODS following severe shock and trauma.

关 键 词：休克 低血容量性 胃肠道 MODS 肠源性脓毒症 

分 类 号：R631.4[医药卫生—外科学]