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不同容量液体复苏对内毒素性休克大鼠小肠基础电节律的影响
The effect of different volume fluid resuscitation on small intestine basic electrical rhythm of endotoxin-induced shock in rats
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DOI:
作者:
傅小云,李康,陈淼 ,喻田
Fu xiaoyun,Li kang,Chen miao,Yu tian
作者单位:
遵义医学院附属医院重症医学科;遵义医学院附属医院麻醉学系
1 The Department of critical care medicine of the Affiliated Hospital of Zunyi medical university;2 The Department of Anaesthesiology of Zunyi medical university, Guizhou Zunyi City 563003
关键词:
内毒素休克;液体复苏;小肠;基础电节律
Endotoxin-induced shock; Fluid resuscitation; Small intestine; Basic electrical rhythm
摘要:
[摘要]目的 探讨不同容量液体复苏对内毒素休克大鼠小肠基础电节律的影响。方法 48只SD大鼠,建立内毒素休克模型,根据液体复苏量随机分为:A、B、C三组,液体复苏速度分别为20ml/kg/h、30ml/kg/h、40ml/kg/h,维持目标血压60-90mmHg ;D组:建立内毒素休克模型,不行液体复苏,以血管活性药物维持目标血压60-90mmHg。观察比较各组休克前(T1)、休克后即刻(T2,建模成功后即刻)、休克后2h(T3)各组小肠基础电节律(小肠慢波电位频率、振幅、频率变异系数(%)及振幅变异系数(%))变化,休克前、复苏2h后各组小肠干、湿重比及休克2h后小肠病理改变。结果 各组大鼠T2时小肠基础电生理活动呈抑制表现,频率、振幅较休克前明显下降,频率变异系数及振幅变异系数较T1明显升高(p<0.01);A组、B组及C组T3小肠电活动较T2明显改善(p<0.01);A组、B组在液体复苏后小肠电活动频率、振幅高于C组,频率变异系数及振幅变异系数低于C组(p<0.05)。休克前后小肠干湿重比较,C组明显增高(p<0.05);肠粘膜损伤评分,A、B、C组明显低于D组(p<0.05)。结论 内毒素休克后小肠基础电节律受到抑制,不同容量液体复苏对小肠基础电生理影响存在差异,中或小剂量液体复苏可改善基础电节律,改善肠道病理或干湿比重,大容量(40ml/h)液体复苏抑制复苏后的肠基础电节律,加剧肠道水肿。
[Abstract] Objective To investigate the effect of different volumes of fluid resuscitation on small intestine basic electrical rhythm in rats with endotoxin-induced shock. Methods 48 rats ,injection with endotoxin lipopolysaccharide to induce an endotoxin shock model, depending on the method of fluid resuscitation, were randomly divided into 4 groups:Group A,B,C(the speeds of fluid resuscitation were 20, 30, 40ml/kg/h respectively) and vasoactive agents were applied to maintain a target blood pressure ranged 60 to 90mmHg if necessary) and Group D (only vasoactive agents were applied to maintain a target blood pressure ranged 60 to 90mmHg). Changes in the coefficient of variation of the slow-wave amplitude (mV), frequency (%), amplitude (%) were measured in each group before shock(T1), immediately after shock (T2) and 2h after shock The ratio of intestinal dry-wet weight and pathological changes were examined at defined time points accordingly.Results The amplitude and frequency of intestinal slow-wave in all groups were decreased and the variation coefficients of slow-wave amplitude and frequency were increased significantly after endotoxin shock (p<0.01);The amplitude and frequency of slow-wave and variation coefficients were improved significantly after fluid resuscitation (p<0.05);The recovery of intestinal basic electrical rhythm in group A and B was superior to group C and D. The ratio of intestinal dry-wet weight in group C was increased significantly compared with group A and B (p<0.05);The scores of intestinal mucosal injury in group A and B were much lower than that of group C (p<0.05). Conclusions The intestinal basic electrical rhythm is inhibited after endotoxin-induced shock in rats. Different volume of fluid resuscitation could restore intestinal basic electrical rhythm to some extent. However, a larger volume of fluid resuscitation (40ml/h) might decrease intestinal basic electrical activity by aggravated intestinal edema.
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