电针足三里穴复合延迟静脉液体复苏对60%血容量失血性休克大鼠的作用研究  

Effect of electroacupuncture at Zusanli point combined with delayed resuscitation on the hemorrhagic shock rats with 60% blood volume

作　　者：钟毓贤[1] 张慧苹 王海滨[3] 吴育寿 马丽千 张文华 姚咏明[2] 胡森[2] Zhong Yuxian;Zhang Huiping;Wang Haibin;Wu Yushou;Ma Liqian;Zhang Wenhua;Yao Yongming;Hu Sen(Department of Rehabilitation Medicine,Six Medical Center of PLA General Hospital,Beijing 100048,China;Research Center of Trauma Repair and Tissue Regeneration,Medical Innovation Research Department,Chinese PLA General Hospital,Beijing 100853,China;Department of Laboratory,Fourth Medical Center of PLA General Hospital,Beijing 100037,China;Burn Institute,Fourth Medical Center of PLA General Hospital,Beijing 100037,China)

机构地区：[1]解放军总医院第六医学中心康复医学科,北京100048 [2]解放军总医院医学创新研究部创伤修复与组织再生研究中心,北京100853 [3]解放军总医院第四医学中心检验科,北京100037 [4]解放军总医院第四医学中心烧伤研究所,北京100037

出　　处：《中华损伤与修复杂志（电子版）》2020年第1期18-25,共8页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：国家自然科学基金项目(81774422)

摘　　要：目的研究电针足三里穴复合延迟静脉液体复苏对60%血容量失血性休克(HS)大鼠生存率、血流动力学、血气指标、脏器血流量和脏器功能的影响。方法选取144只SPF级成年雄性大鼠,制作60%血容量HS模型。大鼠麻醉后置管,沿腹中线剖开腹腔长约4 cm,用浸润0.9%氯化钠溶液的纱布覆盖。从股静脉注射1%肝素0.9%氯化钠溶液行全身肝素化后,从股动脉开始抽血。首先在10 min内从股动脉抽出全身血容量的40%,然后在170 min内利用抽液泵从股静脉缓慢抽取全身血容量的20%,总失血量为大鼠全身血容量的60%,HS模型制作完成,记为休克即刻。(1)实验一,选用72只大鼠HS模型,按随机数字表法分成休克不补液组(HS组)、休克后电针组(HS+EA组)、休克延迟补液组(HS+DFR组)、休克后电针复合延迟补液组(HS+EA+DFR组)。HS组:只进行HS模型制作,不进行针刺和补液。HS+EA组:于HS模型制作完成后30 min针刺双侧足三里穴,不进行补液;HS+DFR组:在休克后3 h用3倍失血量的乳酸林格氏液进行股静脉输液30 min,不进行针刺;HS+EA+DFR组:HS模型完成后30 min针刺双侧足三里穴,休克后3 h进行与HS+DFR组相同的静脉延迟补液。计算4组大鼠休克即刻、休克后3、12、24 h生存率;监测造模前30 min,休克即刻,休克后3、12 h平均动脉压(MAP)和腹腔各脏器血流量。(2)实验二,选择余下72只大鼠HS模型,分组及处理同实验一,计算休克后3 h各组动脉血气和脏器功能指标。数据比较采用单因素方差分析或Kruskal-Wallis秩和检验、t检验、log-rank检验。结果(1)休克即刻,各组生存率均为100.0%,休克后3 h,HS组、HS+EA组、HS+DFR组和HS+EA+DFR组大鼠的生存率分别为61.1%、77.8%、77.8%和88.9%,4组比较差异无统计学意义(P>0.05)。休克后12 h,HS+EA组、HS+DFR组和HS+EA+DFR组大鼠的生存率分别为55.6%、55.6%、61.1%,均显著高于HS组(0),差异均有统计学意义(t=6.51、6.73、6.84,P值均小于0.Objective To study the effect of electroacupuncture at Zusanli point combined with delayed venous fluid resuscitation on survival rate,hemodynamics,blood gas index,blood flow and organ function of 60%blood volume hemorrhagic shock(HS)rats.Methods A total of 144 adult male SPF rats were selected to make a 60%HS model.After anesthesia,the rats were placed into tube,and the abdominal cavity was cut open about 4 cm along the midline of the abdomen,and covered with gauze impregnated with 0.9%sodium chloride solution.After injected 1%heparin saline from the femoral vein for systemic heparin,blood was drawn from the femoral artery.Firstly,40%of the whole body blood was drawn from the femoral artery within 10 minutes,and then 20%of the whole body blood was slowly drawn from the femoral vein using a suction pump within 170 minutes.The total blood loss was 60%of the whole body blood of the rat.HS model was completed and recorded as shock immediately.(1)In experiment one,seventy-two rat HS models were selected and divided into shock non-hydration group(HS group),shock electroacupuncture group(HS+EA group),shock delayed fluid replacement group(HS+DFR group)and electroacupuncture combined delayed fluid replacement group(HS+EA+DFR group)according to the random number table method.HS group:only HS model was made,acupuncture and rehydration were not performed.HS+EA group:acupuncture both sides of Zusanli 30 minutes after the completion of HS model,without rehydration;HS+DFR group:3 h after shock,3 times blood loss of lactated Ringer’s solution for femoral vein infusion for 30 minutes without acupuncture;HS+EA+DFR group:30 minutes after the completion of the HS model,acupuncture both sides of Zusanli point,and 3 hours after shock,the same intravenous delayed rehydration as in the HS+DFR group was performed.Calculate the immediate,3,12,and 24 h aftere shock survival rates of the 4 groups of rats;monitor the mean arterial pressure(MAP)and blood flow in the abdominal organs 30 minutes before the shock,3,12 h after shock.(2)Experim

关 键 词：休克 电针 大鼠 血气分析 延迟补液 

分 类 号：R145[医药卫生—公共卫生与预防医学]