清醒与麻醉大鼠失血性休克后内源性感染的对比观察

Comparative study of occurrence of endogenous infection following hemorrhagic shock in unanesthesized and anesthesized rats

为了阐明麻醉是否会影响休克后内源性感染的发生，对比观察了清醒与麻醉状态下大鼠失血性休克后菌血症、内毒素血症以及血浆肿瘤坏死因子（ＴＮＦ）水平的变化。结果表明：休克９０分钟，清醒组菌血症、内毒素血症发生率分别为５０．０％和７５．０％，麻醉组分别为３７．０％和５０．０％，两组间无显著差异。复苏后即刻，两组菌血症、内毒素血症发生率均分别达５０．０％和６２．０％，两组血浆内毒素水平均较休克前显著升高（Ｐ＜０．０５），但两组间无显著差异。两组血浆ＴＮＦ水平在休克９０分钟开始升高，并在复苏后即刻较休克前显著升高，但两组间血浆ＴＮＦ水平也无显著性差异。实验结果提示：麻醉对大鼠失血性休克后早期内源性感染的发生以及细胞因子反应可能无显著影响作用。

In order to demonstrate the effect of anesthesia on the occurrence of endogenous infection following shock,the study was designed to comparatively investigate the occurrence of bacteremia and the endotoxemia,and the change of plasma tumor necrosis factor (TNF) following hemorrhagic shock in rats under both conscious and unconscious(anesthesized)conditions.It was found that at 90 min following shock,the incidence of bacteremia and endotoxemia in the conscious group was 50% and 75% respectively,and 37% and 50% in the unconscious group.There was no significant difference between the two groups.The incidence of bacteremia and endotoxemia was shown to be 50% and 62% respectively in both groups immediately at the end of resuscitation.Plasma endotoxin levels in the two groups were also shown to be significantly increased at this time,but there was no significant difference between the two groups.Plasma TNF levels in both groups began to rise at 90 min following shock,and became significant at the end of resuscitation.There was also no significant difference between the two groups.The results suggest that anesthesia may not have marked effects on the occurrence of endogenous infection and cytokine response at the early stage of hemorrhagic shock.