口饲乳果糖对失血性休克大鼠预后的影响

为了进一步阐明失血性休克预后与继发性内源性内毒素血症的直接关系，作者探讨了用口饲乳果糖清除肠道内毒素对大鼠失血性休克的保护作用。造成休克前，首先给大鼠口腔管饲２０％乳果糖（５ｍｌ／ｄ）或等容量生理盐水７天，每天给药２次。结果：休克后４８ｈ，乳果糖组大鼠存活率要明显高于盐水组（１０／１０与４／９，Ｐ＜０．０１）。休克后９０ｍｉｎ和１２０ｍｉｎ，乳果糖组大鼠血浆内毒素、ＴＮＦ水平均显著低于盐水组。提示：继发于失血性休克的内源性内毒素血症及肿瘤坏死因子在促使休克向不可逆性发展中可能起重要作用。作者认为，临床上对严重的失血性休克患者，除作复苏外，还应针对感染，尤其是内毒素血症尽早采取防护措施。

Effect of lactulose on the outcome of hemorrhagicshock in rats

This study was designed to further investigate theeffect of endogenous endotoxemia on the prognosis ofhemorrhagic shock induced by oral gavage of lactulose,which is shown to bind and neutralize endotoxins. Ratsreceived oral gavage of 20% lactulose(3ml/day in twodoses) or equal volume of phyxiological saline for sevendays. It was fnund that the survival rate of the shockedanimals in the lactulose-treated group was significantlyhigher than that of the saline group(100% versus 44%,P<0.01).Plasma endotoxin leveL in the lactulose treat-ed group were significantly decreased at 90, 120 min fol-lowing shock compared with those in the saline group(P<0.05 ). In addition, there was also a significant difference in plasma TNF levels between the two groups. Incombination with the previous resuItx, it is concludedthat endogenous endotoxemia plays an important role inthe development of irreversibility of hemorrhagic shock.