不同渗透压液体洗胃对兔胃黏膜的影响  

Effect of gastrolavage with different osmotic pressure solution on gastric mucosa in rabbits

作　　者：刘慧[1] 许铁[2] 周莹[3] 

机构地区：[1]徐州医学院研究生院,江苏徐州221000 [2]徐州医学院附属医院急救中心,江苏徐州221002 [3]徐州医学院附属医院护理部

出　　处：《中国急救医学》2014年第11期1039-1043,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨不同渗透压液体洗胃对兔胃黏膜和血浆渗透压的影响。方法将32只日本长耳大白兔随机分为正常对照组（NC组）、清水组（CW组）、0．45％氯化钠溶液组（HS组）、0．9％氯化钠溶液组（NS组），每组8只。根据重力洗胃法原理进行洗胃。洗胃参数：洗胃液温度37-38℃，进出压力10-15kPa，进液量25mL/kg，周期30s，持续时间40-50min。CW组、HS组、NS组分别用清水、0．45％氯化钠溶液和0．9％氯化钠溶液进行洗胃；NC组仅置胃管不洗胃。在置胃管前及洗胃后，采动脉血；然后用气栓法处死兔，取出胃，在肉眼和光镜下评价胃黏膜损伤程度。结果洗胃前各组兔血浆电解质、渗透压比较差异无统计学意义。洗胃后CW组和HS组血钠浓度[（128．63±7．13）mmol/L和（131．88±4．55）mmol/L]显著下降，与NC组（136．38±3．58）mmol/L和NS组（140．13±0．83）mmol/L比较，差异有统计学意义（P＜0．05）；CW组、HS组和NS组血钾浓度[（2．13±0．35）mmol/L、（2．19±0．36）mmol/L和（2．11±0．24）mmol/L]显著下降，低于NC组（2．73±0．41）mmol/L，差异有统计学意义（P＜0．05）；CW组、HS组和NS组血钙浓度[（1．23±0．12）mmol/L、（1．34±0．13）mmol/L和（1．38±0．10）mmol/L]显著下降，CW组显著低于NS组（P＜0．05）。CW组和HS组洗胃前后血浆渗透压显著下降[（295．59±11．75）mmol/Lvs（269．32±13．94）mmol/L和（290．99±5．52）mmol/Lvs（278．96±8．66）mmol/L）]，也显著低于洗胃后NC组（290．74±6．11）mmol/L和NS组（292．56±2．59）mmol/L，差异有统计学意义（P＜0．05）。NS组、HS组和CW组胃黏膜损伤指数（28．88±14．63、42．63±21.03和48．25±17．27）较NC组（0．38±0．74）显著升高，CW组显著高于NS组（均P＜0．05）；NS组、HS组和CW组胃黏膜上皮损伤评分（2．88±2.03、3．50±2．14和5．50±2．20）较NC组（0.25±0．46Objective To study the effect of gastrolavage with different osmotic pressure solution on gastric mucosa in rabbits.Methods Thirty-two rabbits were randomly divided into four equal groups：normal control （NC） group, clear water （CW） group, 0.45% sodium chloride solution （ HS） group, 0.9%sodium chloride solution （ NS） group.After the rabbits were anesthetized, we give them gastric lavage with homemade improvised gastric lavage apparatus.The blood samples of each group were collected at pre -gastrolavage and post -gastrolavage, plasma electrolytes were measured and plasma osmotic pressure was calculated.At the end of the experiment, the rabbits were sacrificed, then stomachs were removed.The injury level of the gastric mucosa was observed by the naked eyes and light. Results Before gastrolavage, plasma electrolytes and osmotic pressure did not show significant difference among the groups （P〉0.05）.After gastrolavage, plasma sodium concentration in CW group and HS group [（128.63 ±7.13）mmol/L, （131.88 ±4.55）mmol/L] significantly decreased and were lower than that in NC group and NS group [（136.38 ±3.58）mmol/L],（140.13 ±0.83）mmol/L,P〈0.05].Plasma potassium concentration in CW group, HS group and NS group [（2.13 ±0.35）mmol/L,（2.19 ±0.36）mmol/L,（2.11 ±0.24）mmol/L]significantly decreased and were lower than that in NC group[（2.73 ±0.41）mmol/L,P〈0.05].Plasma calcium concentration in CW group, HS group and NS group [（1.23 ±0.12）mmol/L,（1.34 ±0.13）mmol/L,（1.38 ±0.10）mmol/L] significantly decreased compared with that of pre-gastrolavage [（1.38 ±0.12）mmol/L,（1.42 ±0.08）mmol/L, （1.43 ±0.08）mmol/L,P〈0.05].Plasma calcium concentration in CW group was lower than that in NS group （P〈0.05）.Plasma osmotic pressure in CW group and HS group [（269.32 ±13.94）mmol/L,（278.96 ±8.66） mmol/L] significantly decreased and were lower than that in NC group and NS group [（290.74 ±6.11）mmol/L,（292.56 ±2.59）mmol/L,P〈0.05].Th

关 键 词：兔 洗胃液 血浆电解质 血浆渗透压 黏膜损伤 

分 类 号：R245.93[医药卫生—针灸推拿学]