漂白土洗胃联合清胰Ⅱ号导泻对口服百草枯中毒兔的治疗观察  

Therapeutic effects of gastric lavage with fuller earth combined with QingyiⅡ catharsis in treatment of oral paraquat poisoning in rabbits

作　　者：陆元兰[1] 周满红[2] 胡杰[3] 李建国[1] 

机构地区：[1]遵义医学院附属医院急诊科,贵州遵义563003 [2]遵义医学院附属医院干部保健病房,贵州遵义563003 [3]遵义医学院附属医院重症医学科,贵州遵义563003

出　　处：《中华危重病急救医学》2015年第4期250-253,共4页Chinese Critical Care Medicine

基　　金：国家自然科学基金（81460291）;贵州省遵义市科技计划项目（遵市科合社字（2013）42号]

摘　　要：目的探讨漂白土洗胃联合清胰Ⅱ号导泻对口服百草枯中毒兔的治疗作用。方法成年健康日本大耳白兔30只，按照随机数字表法分为对照组、模型组、洗胃组（10%漂白土混悬液洗胃）、导泻组（清胰Ⅱ号导泻）、联合组（漂白土混悬液洗胃后10 min行清胰Ⅱ号导泻）5组，每组6只。一次性灌胃百草枯溶液100 mg/kg（用生理盐水稀释至5 mL）制备急性中毒模型；对照组灌胃等量生理盐水。各治疗组于灌胃1 h后进行相应治疗，连续3 d。观察动物存活情况；于中毒后1、2、4、8、24 h取耳缘静脉血，用紫外分光光度计检测血浆百草枯浓度；于中毒后8 d静脉注射空气处死动物取右肺下叶，苏木素-伊红（HE）染色，观察肺组织病理学改变。结果①存活情况：中毒后2 d各组兔存活数为联合组（6只）＞洗胃组（5只）＞导泻组（2只）＞模型组（0只），7 d存活数为联合组（5只）＞洗胃组（3只）＞导泻组（0只），差异均有统计学意义（P＜0.001和P＝0.003）。②血浆百草枯浓度：各组血浆百草枯浓度的吸收高峰在中毒后2 h，但洗胃组、导泻组、联合组血浆百草枯浓度均已明显低于模型组（mg/L：1.830±0.068、1.890±0.048、1.800±0.052比1.960±0.063，均P＜0.01）；随治疗时间延长，血浆百草枯血中浓度下降幅度为联合组＞洗胃组＞导泻组（均P＜0.01）；析因分析联合组4 h时洗胃和导泻出现交互作用〔F＝5.194，P＝0.034，百草枯浓度（mg/L）为0.670±0.057比1.010±0.018、1.210±0.052〕。③肺组织病理学改变：模型组、导泻组肺泡壁毛细血管明显扩张充血，肺泡间隔增宽，可见大量炎性细胞浸润；洗胃组、联合组肺损伤病理改变较模型组明显减轻，且联合组较洗胃组改善更明显。结论早期采用漂白土混悬液洗胃联合清胰Ⅱ号导泻能降低口服百草枯中毒兔血浆百草枯浓度，改善肺损伤程度ObjectiveTo observe the therapeutic effects of gastric lavage with fuller earth combined with QingyiⅡ catharsis in treatment of oral paraquat poisoning in rabbits.Methods Thirty healthy adult Japanese white rabbits were randomly divided into five groups： namely control group, model group, gastric lavage group （lavage of 10%fuller earth suspension）, catharsis group （QingyiⅡ catharsis）, and combination group （10 minutes after gastric lavage of fuller earth suspension liquid, giving QingyiⅡ for catharsis）, with 6 rabbits in each group. All groups were challenged with paraquat （100 mg/kg） diluted to 5 mL with normal saline by lavage to reproduce the model of acute poisoning, while the control group was given 5 mL of normal saline instead. Each treatment group was treated accordingly at 1 hour after gavages of paraquat, and treatment continued for 3 days. The animal survival rate was observed. Venous blood samples were collected from ear marginal vein to determine the plasma concentration of paraquat by ultraviolet spectrophotometer at 1, 2, 4, 8 and 24 hours after the poisoning. The animals were sacrificed by intravenous air injection on the 8th day after the poisoning, and the right lower lobe of lung was harvested to observe the lung tissue pathological changes with hematoxylin-eosin （HE） staining.Results① Survival rate： the surviving rate of the combination group （6 rabbits） was higher than that of gastric lavage group （5 rabbits）, catharsis group （2 rabbits） and model group （0 rabbit） on the 2nd day with statistically significant difference （P〈 0.001）. The survival rate on the 7th day in combination group （5 rabbits） was higher than that of gastric lavage group （3 rabbits）, and catharsis＆amp;nbsp;group （0 rabbit） with statistically significant difference （P = 0.003）.② Plasma concentrations of paraquat： plasma paraquat concentration in all groups peaked at 2 hours after intoxication, and its levels in the gastric lavage, catharsis and comb

关 键 词：中毒 百草枯 漂白土 清胰Ⅱ号 洗胃 导泻 QingyiⅡ 

分 类 号：R259[医药卫生—中西医结合]