两种液体复苏对失血性休克大鼠细菌移位及肠道炎症反应的影响

目的探讨复方氯化钠溶液（林格液，RS）和质量分数为6％的中分子羟乙基淀粉溶液（HES）对失血性休克大鼠细菌移位及肠道炎症反应的影响。方法50只健康雄性SD大鼠按随机数字表法分为假手术组（SHA组，n=10）、RS组n=20）、HES组（n=20），RS组和HES组制备可控性失血性休克模型。分别于液体复苏后1h和24h处死大鼠，检测和比较各组大鼠细菌移位、肠组织肿瘤坏死因子-α（TNF—α）及髓过氧化物酶（MPO）活性的变化，并进行病理学检查。结果HES组和RS组在死亡率、放血量、病理学检查方面没有明显差别。与SHA组比较，HES组和RS组在菌落计数和TNF—α方面明显升高，其中HES1h组比RS1h组明显升高，HES 24h组比RS24h组明显下降。与SHA组比较，HES1h组和RS1h组的MPO活性明显升高，HES24h组和RS24h组MP0活性没有明显差别。结论RS能明显改善复苏后1h的肠道功能，HES能明显改善复苏后24h的肠道功能。

Comparison of effects of two kinds of fluid for resuscitation on bacterial translocation and inflammation of small intestine in rats with hemorrhagic shock

OBJECTIVE: To investigate the effects of Ringer's solution (RS) or 6% hydroxyethyl saline (HES) on bacterial translocation and inflammation of the small intestine in rats with hemorrhagic shock. METHODS: Fifty healthy male SD rats were randomly divided into the sham group (SHA group, n=10), the Ringer's solution group (RS group, n=20) and 6% hydroxyethyl saline group (HES group, n=20). Controlled hemorrhagic shock model was reproduced in RS and HES groups. Bacterial translocation to the liver, the content of tumor necrosis factor-alpha (TNF-alpha) in intestinal tissue, and the myeloperoxidase (MPO) activity in the intestinal tissue were determined and compared among the groups, and the pathologic changes in the small intestine were observed. RESULTS: The mortality rate, bleeding volume and Chiu's scores were same in HES and RS groups (all P>0.05). Compared to SHA group, bacterial count and TNF-alpha level were increased significantly in HES and RS groups, and they were higher at 1 hour and lower at 24 hours in HES group than those in RS group. Compared to the SHA group, MPO activity increased at 1 hour in RS and HES groups, but no significant difference between the groups was found at 24 hours. CONCLUSION: RS prevents compromise of the intestinal barrier function better than the HES at 1 hour after fluid resuscitation. However, HES seems to be better in protecting the intestinal barrier function compared with RS at 24 hours after fluid resuscitation.