血浆灌流治疗腹部开放伤海水浸泡犬肝功能损伤的研究

目的 探讨血浆灌流对腹部开放伤后海水浸泡实验犬肝功能损伤的治疗作用.方法24只腹部开放伤实验犬分为对照组(海水浸泡1.5 h后打捞出水,单纯观察),普通治疗组(海水浸泡后打捞出水,给予一般的急救及补液处理)和血浆灌流组(经海水浸泡后打捞出水,给予一般的急救补液处理,30 h后给予血浆灌注治疗),每组8只.于致伤前及致伤后定时取血测定总胆红素(TB)、血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、凝血酶原时间(PT)、内毒素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6),同时对肝组织进行病理检查.结果 对照组和普通治疗组血清TB、ALT、AST和LDH明显升高,血浆灌流组灌流后ALT、AST、LDH、TB、内毒素、TNF-α比灌流前明显下降(P<0.05),血细胞、血小板数量与普通治疗组比较明显下降.结论 血浆灌流对外伤后海水浸泡导致的实验犬肝功能损伤的治疗效果良好,此法可应用于该类肝损害的治疗.

Study of hemoperfusion in liver function damage caused by seawater immersion in experimental dogs with open abdomen injury

Objective To explore therapeutical effect of hemoperfusion on liver function damage caused by seawater immersion in experimental dogs with open abdomen injury. Methods Twenty-four experimental dogs after open abdomen injury were randomly divided into three groups. Control group (n=8) was observed only after seawater immersion for one and half an hours. Common treatment group (n=8) was given emergency cure and infused solution after seawater immersion. Hemoperfusion group (n=8) was firstly given the same therapy as common treatment group, then treated by hemoperfusion at the 30th hour. Blood samples were taken before wound and at different time intervals after wound to measure the levels of bilirubin total (TB) and alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), endotoxin, TNF-αand IL-6 in serum,and prothrombin time (PT), and the pathological changes in hepatic tissue were also examined. Results The levels of TB, ALT, AST and LDH in serum in control group increased significantly. Those in common treatment group did also. The levels of ALT, AST, LDH, TB, endotoxin and TNF-α in hemoperfusion group decreased, but blood corpuscle and blood platelet were influenced evidently. Conclusions Hemoperfusion has a good therapeutic efficacy on liver function demage caused by seawater immersion after open abdomen injury. It can be applicated in therapy for hepatic lesion.