腹腔复苏对失血性休克大鼠肺损伤的保护作用

目的探讨腹腔复苏对失血性休克大鼠肺损伤的保护作用。方法健康雄性SD大鼠40只,随机分成假手术组(Ⅰ组)、失血性休克组(Ⅱ组)、静脉复苏组(Ⅲ组)、PD-2液腹腔复苏加静脉复苏组(Ⅳ组)。Ⅰ组依次行右颈总动脉、右股静脉、左股动脉插管及全身肝素化;Ⅱ组在Ⅰ组基础上制备失血性休克大鼠模型;Ⅲ组在Ⅱ组基础上于造模后经右股静脉补入放出的血量及2倍量林格氏液进行静脉复苏;Ⅳ组在Ⅲ组基础上同时腹腔内注入30 mL2.5%PD-2液。各组分别于T0、T1、T2进行PaO2/FiO2值血气分析;T2时测定肺组织W/D比值,TNF-α、IL-1β、IL-10的含量,观察肺组织病理学结果。结果与Ⅰ组比较,Ⅱ组PaO2/FiO2值明显降低,Ⅲ组于T0、T2时下降明显,Ⅳ组T0时下降明显;与Ⅰ组比较,Ⅱ组、Ⅲ组、Ⅳ组肺组织TNF-α、IL-1β、IL-10的含量和W/D比值均升高(P<0.01),与Ⅱ组比较,Ⅲ组和Ⅳ组降低,Ⅳ组肺组织IL-10含量升高(P<0.05或P<0.01)。与Ⅳ组比较Ⅲ组肺组织IL-10含量降低;肺组织病理学比较,Ⅱ组较Ⅰ组有明显损伤,Ⅳ组病理损伤最轻。结论 PD-2液腹腔复苏能够减轻失血性休克大鼠肺组织损害的程度,降低炎症反应,对肺损伤具有保护作用。

The protective effects of intra-peritoneal fluid resuscitation on hung injury in rats with hemorrhagic shock

Objective To investigate the protective effects of intra-peritoneal fluid resuscitation on hung injury in rats with hemorrhagic shock.Methods Fifty Sprague-Dawley(SD) rats were randomly divided into sham operation group(group Ⅰ),hemorrhagic shock group(group Ⅱ) intra-venous fluid resuscitation group(group Ⅲ) and intravenous fluid resuscitation plus intra-peritoneal PD-2 solution resuscitation group(group Ⅳ).The rats of 4 groups were processed with cannulations of right common carotid artery,right femoral vein and left femoral artery with systemic heparinization.The rat models of hemorrhagic shock were established with modified Wigger′s method.The rats of group Ⅲ were resuscitated with shed blood plus twice equal volume of Ringer′s solution after modeling of hemorrhagic shock.The rats of group Ⅳ were administered intra-peritoneally with 30 mL of 2.5% PD-2 solution,respectively as adjuncts to those used in the group Ⅲ.Blood gas was analyzed T0,T1,T2,and calculation PaO2/FiO2;Observed wet/dry W/D ratio,TNF-α,IL-1β,IL-10 content in lung tissue at T2.Results Compared with group Ⅰ,PaO2/FiO2 level of group Ⅱ was significantly lower at T0、T2,group Ⅲ decreased significantly,group Ⅳ decreased significantly at T0;and TNF-α,IL-1β,IL-10 and W/D levels of group I,Ⅱ,Ⅲ,Ⅳ were significantly increased(P<0.01),group Ⅲ and Ⅳ decreased compared with group Ⅱ,IL-10 content of group Ⅳ increased(P<0.05).Of lung histopathology,group Ⅱ had significantly more damage than group Ⅰ,group Ⅳ had lightest pathological damage.Conclusion PD-2 intra-peritoneal resuscitation can reduce the extent of damage in hemorrhagic shock of rats,decrease the inflammatory response,and has a protective effect against lung injury.