目标导向的早期限制性液体复苏对沙漠干热环境下失血性休克兔模型器官功能和氧化应激水平的影响  

Effects of target-directed early limited fluid resuscitation on organ function and oxidative stress level of desert hot and dry environment induced hemorrhagic shock rabbit model

作　　者：周帅 郑杰 杨博 吴冬惠 顾伏平 Zhou Shuai;Zheng Jie;Yang Bo;Wu Donghui;Gu Fuping(Department of general surgery,people's liberation army 63600 military hospital,Lanzhou,Gansu,735000,China)

机构地区：[1]解放军63600部队医院普外科,甘肃兰州735000

出　　处：《齐齐哈尔医学院学报》2021年第20期1754-1757,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨限制性液体复苏对沙漠干热环境创伤失血性休克兔器官功能的保护作用。方法选取健康家兔45只,随机分为假手术组、模型组和治疗组三组,每组各15只。将模型组的家兔置于人工实验舱内3 h模拟沙漠干热环境,然后将其麻醉并行脾脏及部分肝脏的切除术,再于左侧股动脉处放血;治疗组则在模型组的基础上给予限制性液体复苏治疗;假手术组则仅行腹中线剖腹术作为假手术对照。观察各家兔肝肾功能和肺组织中的炎症因子和氧化应激指标,以及血气分析指数情况。结果假手术组的肾脏功能指标的水平均低于模型组,差异均有统计学意义(P<0.05)。治疗组的肾脏功能指标水平高于模型组,差异有统计学意义(P<0.05)。正常组肺组织的炎症指标和氧化应激指标的水平均低于模型组,治疗组的炎症指标和氧化应激指标水平明显高于模型组,差异均有统计学意义(P<0.05)。假手术组的肝脏功能指标的水平均低于模型组,治疗组的肝脏功能指标的水平高于模型组,差异均有统计学意义(P<0.05)。正常组的血气分析的指数水平高于模型组,治疗组的血气分析的指数水平明显低于模型组,差异均有统计学意义(P<0.05)。结论早期限制性液体复苏可明显地改善沙漠干热环境创伤失血性休克导致的肺、肾和肝脏的损伤,值得临床推广应用。Objective To investigate the protective effect of restrictive fluid resuscitation on organ function in rabbits with traumatic hemorrhagic shock in desertdry-heat environment.Methods Forty-five healthy rabbits were randomly divided into sham operation group,model group and treatment group,with 15 rats in each group.The rabbits in the model group were placed in the artificial experimental chamber for 3 hours to simulate the dry heat environment of the desert,then anesthetized and the spleen and part of the liver were resected,and then the left femoral artery was bled.The treatment group was given a limited fluid resuscitation treatment based on the model group;the abdominal mid-line laparotomy was only used as a sham control in the sham operation group.The function of liver and kidney,the inflammatory indexes and oxidative stress index of lung,and blood gas analysis were observed.Results The level of renal function index in sham operation group was significantly lower than that in the model group(P<0.05).The level of renal function in the treatment group was significantly higher than that in the model group(P<0.05).The levels of inflammation index and oxidative stress indexin the normal lung tissue were significantly lower than those of the model group(P<0.05),and the levels of inflammation index and oxidative stress index in treatment group were significantly higher than those of the model group(P<0.05).The level of liver function in the Sham operation group was significantly lower than that in the model group(P<0.05),the level of liver function index in the treatment group was significantly higher than that in the model group(P<0.05).The index level of blood gas analysis in the Sham operation group was significantly higher than that in the model group(P<0.05),and the index level of blood gas analysis in the treatment group was significantly lower than that in the model group(P<0.05).Conclusions Restrictive fluid resuscitation could significantly improve lung,kidney and liver damage caused by hemorrhagic shock in

关 键 词：早期限制性液体复苏 沙漠干热环境创伤失血性休克 肝脏 肾脏 肺脏 氧合指数 家兔 

分 类 号：R459.4[医药卫生—治疗学]