大鼠烧伤休克延迟复苏肠道微血流量的改变及其与细菌移位的关系

目的　探讨烧伤休克期延迟复苏肠道局部微循环改变及其与肠道细菌移位的关系。方法　采用大鼠烧伤休克延迟复苏模型 ,动物分为烧伤休克不复苏组、伤后 8h延迟复苏组、立即复苏组和手术对照组 ,检测肠道细菌移位发生频率、回肠末端肠壁微血流量和体循环平均动脉压变化。　结果　伤后 8h复苏组细菌移位率高达 5 4.2 % ,明显高于立即复苏组 (P <0 .0 1) ,与不复苏组相差不显著 (P >0 .0 5 ) ;延迟复苏后 4h ,肠壁微血流量虽已得到改善 ,但远未达到立即复苏组同时相的微循环血流灌注量 ,而此时外周循环的平均动脉压已恢复至正常范围。　结论　烧伤休克延迟复苏后肠道细菌移位频率居高不下 ,可能与肠壁微血流量改善滞后有关

The change of intestinal microcirculation blood flow and its relationship with bacterial translocation in burned rats receiving delayed fluid resuscitation

OBJECTIVE: To investigate the change of intestinal microcirculation blood flow and its relationship with bacterial translocation in burned rats receiving delayed fluid resuscitation. METHODS: Twenty-four Wistar rats inflicted by 30% TBSA III degree followed by delayed fluid resuscitation were taken as the model. The rats were randomly divided into four groups, i.e. burn shock without resuscitation (BSNR), delayed resuscitation (fluid given from 8 hours postburn, DR), immediate resuscitation (IR), and sham operation (SO). The incidence of bacterial translocation, intestinal microcirculation blood flow volume of intestinal wall at terminal ileum as well as the change of systemic mean arterial pressure were monitored. RESULTS: The incidence of bacterial translocation in DR group (54.2%) was significantly higher than that in IR group (P < 0.01), but no remarkable difference with that in BS group (P < 0.05). In addition, microcirculation blood flow of intestinal wall recovered to some degree at 4 hours after delayed fluid resuscitation but far below that in IR group at the same time point. Nevertheless, the systemic mean arterial blood pressure had restored to the normal range at that time. CONCLUSION: The incidence of intestinal bacterial translocation sustained at high level after burn shock with delayed fluid resuscitation, which might be the result of delayed improvement of microcirculation blood flow of the intestinal wall.