腹腔间隔室综合征模型兔肺脏病理学改变的实验研究  

Experimental study on the pathological changes in lung of abdominal compartment syndrome model rabbits

作　　者：王宏业[1] 尉继伟[1] Wang Hongye;Yu Jiwei(Department of Oncology,the Affiliated Hospital of Datong University,Datong 037005,Shanxi,China)

机构地区：[1]大同大学附属医院肿瘤科,山西大同037005

出　　处：《中华危重病急救医学》2019年第1期112-114,共3页Chinese Critical Care Medicine

基　　金：山西省重点研发计划项目(201603D321054);山西大同科技攻关项目(201497).

摘　　要：目的探讨腹腔间隔室综合征(ACS)继发肺脏病理学改变的特点。方法健康成年清洁级新西兰兔25只,按随机数字表法分为对照组(n=5)和实验组(n=20),实验组再按照观察时间分为24h和48h两个亚组,每个亚组10只。采用水囊叠加加压法制备腹腔高压液体动物模型。对照组加压水囊不注液,维持腹内压(IAP)为0;实验组加压水囊注液,维持IAP为25mmHg(1mmHg=0.133kPa)。对照组于48h、实验组分别于24h和48h处死动物,完整取出肺脏,苏木素-伊红(HE)染色后,光镜下观察病理学改变。结果对照组动物活动度下降,进食量减少,5只均存活;实验组动物呈球状腹,活动显著减少,少量进食或不进食,尿量明显减少,分别在22、27、37h各死亡1只,存活17只。光镜下显示:对照组肺组织可见终末细支气管和大量肺泡,间质内小血管扩张。实验组24h肺泡上皮增生,肺泡间隔大小不一,小灶肺泡腔融合,肺泡间隔出血,肺间质内可见胞质内形成含铁血黄素的巨噬细胞(即心衰细胞),细支气管扩张,支气管旁可见大量炎性细胞浸润,血管内可见血栓形成;48h终末细支气管腔内可见大量红细胞及纤维素样渗出物,肺泡扩张融合加重,肺泡腔内陈旧性出血,可见含铁血黄素沉着。结论ACS可造成严重的肺脏损伤,且随时间延长逐渐加重。Objective To investigate the secondary pathological changes in lung of abdominal compartment syndrome (ACS). Methods Twenty-five healthy adult clean New Zealand rabbits were randomly divided into control group (n = 5) and experimental group (n = 20) according to the random number table method. The experimental group was subdivided into two subgroups according to the observation time: 24 hours and 48 hours, with 10 rabbits in each subgroup. A high pressure liquid animal model of abdominal cavity was reproduced by water bag superposition pressurization. In the control group, the pressurized water bag did not inject liquid, and intra-abdominal pressure (IAP) was maintained at 0;while in the experimental group, pressurized water infusion was performed, and IAP was maintained at 25 mmHg (1 mmHg = 0.133 kPa). The rabbits in the control group were sacrificed at 48 hours, those in the experimental group were sacrificed at 24 hours and 48 hours respectively, and the lungs were harvested completely. The pathological changes were observed under light microscope after hematoxylin-eosin (HE) staining. Results In the control group, the activity of the rabbits was decreased, the food intake was decreased, and all the 5 animals survived;in the experimental group, the activity was decreased significantly, little food intake or not, the urine output was decreased significantly, and 1 rabbit died at 22, 27 and 37 hours respectively, and 17 survived. Light microscopy showed that there were terminal bronchioles and a large number of alveoli in the lung tissue of the control group, and small vessels dilated in the interstitium. In the experimental group, alveolar epithelial hyperplasia, alveolar septum of different sizes, alveolar fusion, alveolar septal bleeding, interstitial heart failure cells with phagocytosis of hemosiderin, bronchiolectasis, a large number of inflammatory cell infiltration near the bronchi, thrombosis in the blood vessels were found at 24 hours. A large number of erythrocyte and cellulose-like exudates were seen

关 键 词：腹腔间隔室综合征 肺脏 动物模型 动物实验 

分 类 号：R459.7[医药卫生—急诊医学] R-332[医药卫生—治疗学]