氧疗对高原失血性休克家兔肠黏膜屏障的影响

目的 探讨氧疗对高原失血性休克动物肠道损伤的保护作用。方法 15只家兔随机分为实验 组和对照组。模拟高原环境,在低压舱内减压至海拔4 000 m,经股动脉放血使其平均动脉压(MAP)降至 40 mm Hg(1 mm Hg=0.133 kPa),实验组动物给予氧浓度(FiO2)为0.80的O2吸入,并回输全部失血量及 1.5倍失血量的平衡盐溶液抗休克治疗;对照组只给予抗休克治疗。结果 与对照组相比,实验组动物的 MAP于治疗后4 h显著高于对照组同期水平(P<0.05);而治疗后h和8 h实验组的血浆乳酸水平显著低 于对照组(P<0.01和P<0.05);血浆内毒素水平在治疗后显著低于对照组(P<0.05和P<0.01);实验组 动物的小肠黏膜损伤程度明显轻于对照组。结论高原失血性休克可以造成肠黏膜屏障损伤,氧疗对高原失 血性休克家兔的肠黏膜具有明显保护作用。

Effect of oxygen therapy for injury of intestinal mucosal barrier of rabbits in high altitude hemorrhagic shock

Objective To investigate the protective effects of oxygen therapy on gut barrier function of rabbits after hemorrhagic shock at high altitude. Methods Fifteen rabbits were exposed to a simulated 4 000 m high altitude in a hypobaric chamber, and they were randomly divided into two groups of treatment and control. Then hemorrhagic shock was induced through bleeding to mean artery pressure 40 mm Hg (1 mm Hg = 0.133 kPa). After 1 hour, the rabbits were resuscitated with infusion of total volume of shed blood and balanced saline equivalent to 1. 5 times of the shed blood. In addition, the animals of the treatment group were given oxygen therapy. Results After 4 hours treatment, the mean arterial pressure of the treatment group was increased significantly in comparison with the control group, and the concentrations of plasma lactate in the former were significantly decreased after treatment for 4 hours and 8 hours. The plasma lipopolysaccharide levels in the treatment group were significantly lower than those in the control after treatment, and the histologic evidence of damage to the intestinal mucosa of the rabbits in the treatment group was less marked than that in the control group (P<0.05 or P<0. 01). Conclusion Hemorrhagic shock at high altitude may cause disruption of the intestinal mucosa barrier and oxygen therapy could afford protection to the intestinal mucosa barrier in such circumstance.