羟乙基淀粉对大耳兔腹部大手术术后微血管清蛋白渗漏的影响  

The effects of hydroxyethyl starch on microvascular albumin leakage after major abdominal surgery in rabbits

作　　者：李为明[1] 徐鹏远[1] 岑云云[1] 陈雄志[1] 袁震[1] 杨婷[1] 李健[1] 孙大力[1] 李树民[1] 许青文[1] 李奕俊[1] 

机构地区：[1]昆明医科大学第二附属医院干疗外科,云南昆明650101

出　　处：《肠外与肠内营养》2015年第1期39-41,共3页Parenteral & Enteral Nutrition

基　　金：国家自然科学基金(81160114)

摘　　要：目的:羟乙基淀粉(HES)对大耳兔腹部大手术术后早期肠系膜微血管清蛋白(ALB)渗漏的影响,为防止腹部大手术术后早期微血管ALB渗漏提供理论依据。方法:取大耳兔18只,随机分为对照组、等渗盐水组和HES组。对照组不给予任何干预,后两组均行胃大部切除加胰体尾、脾切除术,术后采用等热量和等氮量营养支持,等渗盐水组术后给予25 ml/(kg·d)等渗盐水,HES组术后给予6%HES(130,0.4)25 ml/(kg·d)。术前和术后48 h检测血清ALB浓度,三组兔术后48 h通过静脉注射异硫氰酸罗丹明B标记的牛血清ALB,在激光共聚焦显微镜下动态观察大耳兔肠系膜微血管ALB渗漏情况,并计算其微血管(ALB)渗透率。结果:三组大耳兔术前血清ALB浓度差异无统计学意义(P>0.05)。HES组大耳兔术后48 h血浆ALB浓度明显升高,与等渗盐水组比有显著性差异(P<0.05),微血管ALB渗漏明显降低(P<0.05)。结论:大耳兔腹部大手术术后早期存在低ALB血症,给予HES可减少早期微血管ALB渗漏,提高术后早期血浆ALB浓度。Objective： To evaluate the effects of hydroxyethyl starch on microvascular albumin leakage after major abdominal surgery in rabbit. Methods： 18 male Japanese rabbits were randomly divided into three groups,normal control group,saline group and hydroxyethyl starch group. The rabbits of saline group and hydroxyethyl starch group underwent gastrectomy plus distal pancreatectomy,splenectomy. All rabbits were nourished by equal calorie and nitrogen postoperative. Serum albumin concentration was detected at preoperative and postoperative 48 h. After intravenous injection of rhodamine isothiocyanate B labeled bovine serum albumin,mesentery microvascular albumin leakage of the rabbit was observed dynamicly by laser sacanning confocal microscope and its microvascular serum albumin leakage ratio was calculated. Results： Serum albumin concentrations were not significantly different among three groups. Serum albumin concentration of hydroxyethyl starch group was significantly higher compared with the saline group（ P〈0. 05）. The leakage rate of microvascular albumin of hydroxyethyl starch group was significantly lower compared with the saline group（ P〈0. 05）. Conclusion： The hydroxyethyl starch can reduce early microvascular albumin leakage after major abdominal surgery in rabbit.

关 键 词：大耳兔 羟乙基淀粉 微血管清蛋白渗漏 

分 类 号：R965[医药卫生—药理学]