高渗盐胶体对失血性休克大鼠小肠黏膜形态的影响

目的:研究小容量高渗盐羟乙基淀粉液(HSH)复苏失血性休克大鼠时肠黏膜形态的变化和血清NO浓度变化.方法:SD大鼠麻醉后放血致平均动脉压40mmHg±5mmHg,维持30min,SD大鼠随机分成3组:(1)高渗盐羟乙基淀粉复合液+回输失血(HSH组);(2)乳酸林格液复苏+回输失血(LR组);(3)假休克组,只进行血管置管;观察休克前后血浆NO浓度的动态变化,并留取小肠组织观察病理改变.结果:HSH组大鼠复苏后血浆NO无明显下降,复苏前(30.03μmol/L±4.77μmol/L)和复苏后(27.33μmol/L±8.76μmol/L)比较,无显著差异(P>0.05),小肠的病理损伤也显著减轻.LR组血浆NO浓度明显降低,复苏前(28.37μmol/L±6.24μmol/L)和复苏后(17.48μmol/L±5.24μmol/L)比较,有显著差异(P<0.05),小肠的病理损伤无明显改善.结论:应用HSH有助于改善失血休克引起的肠道损伤;其机制可能与HSH减少内皮细胞功能损害有关.

Hypertonic sodium chloride hydroxyethyl starch injection reduces histopathological changes in the intestinal mucosa of rats with hemorrhagic shock

AIM:To evaluate the effect of small-volume hypertonic sodium chloride hydroxyethyl starch injection on histopathological changes in the intestinal mucosa and plasma levels of NO in rats with hemorrhagic shock.METHODS:Male SD rats were hemorrhaged to the mean arterial pressure of 40 mmHg±5 mmHg for 30 min to induce hemorrhagic shock.Animals were randomly divided into three groups:rats resuscitated with 4 mL/kg of 5.0% hypertonic sodium chloride hydroxyethyl starch injection and retransfused shed blood,those resuscitated with lactated Ringer’s solution(two times the volume of shed blood)and retransfused shed blood,and those undergoing sham hemorrhage.The dynamic changes in plasma NO concentrations were monitored,and pathological changes in the small intestine were observed.RESULTS:After resuscitation with hypertonic sodium chloride hydroxyethyl starch injection,NO showed no significant changes(P>0.05),and pathological changes in the small intestine were significantly reduced.In contrast,plasma NO concentration significantly decreased(P< 0.05)and pathological damage to the small intestine showed no significant improvement in rats resuscitated with lactated Ringer’s solution.CONCLUSION:Resuscitation with hypertonic sodium chloride hydroxyethyl starch injection reduces intestinal damage in rats hemorrhagic shock possibly via a mechanism associated with protection of endothelial cell function.