山莨菪碱对失血性休克兔小肠微循环血量及血液酸碱度的影响

Effect of scopolamine on the small intestinal mueosa mierocirculation blood flow and blood gas in rabbits with hemorrhage shock

目的观察山莨菪碱对失血性休克兔小肠微循环血流量及血液酸碱度变化情况。方法大白兔16只随机分为2组，分别是山莨菪碱治疗组（S组，n=8）和生理盐水对照组（C组，n=8）。复制兔重度失血性休克及复苏的动物模型，在休克期间分别予等容量的山莨菪碱注射液和生理盐水治疗，复苏60min。观察放血前、放血后10、30、60min小肠黏膜微循环血流量、动脉平均血压、中心静脉压。在放血前、放血后10、30、60min取颈动脉、肠系膜上静脉血液少量进行血气分析。结果放血后两组动物休克期小肠黏膜微循环血流量均比放血前明显降低（P〈0．05）；回输血液后S组动物小肠微循环血流量恢复，与放血前比较差异无统计学意义（P〉0．05）；C组动物在再灌注10、30、60min时的微循环血流量明显低于放血前（P〈0．05）。在再灌注60min时S组的颈动脉血pH值、BE值高于c组（P〈0．05）；而对肠系膜上静脉血，S组在再灌注30、60min时的pH值高于C组，在再灌注10、30、60min时的BE值高于C组（P〈0．05）。结论山莨菪碱能改善失血性休克时肠黏膜微循环，有利于更快清除肠微循环蓄积的酸性物质。

Objective To investigate the effect of scopolamine on the small intestinal mucosa microcirculation blood flow and blood gas in rabbits with hemorrhage shock. Methods Sixteen healthy white rabbits were randomly divided to receive scopolamine as therapeutic drugs （group S, n = 8） and saline as control （group C, n = 8） respectively. Hemorrhage/resuscitation animal model was established according to the Wigger＇s method. The small intestinal mucosa microcirculation blood flow, MAP and CVP were measured during hemorrhage shock/resuscitation process. Blood gases of femoral artery and superior mesenteric vein blood samples were detected. Results During hemorrhage shock, the small intestinal mucosa microcirculation flow was decreased obviously in both two groups. At 10, 30 and 60 min after blood re-transfusion, the blood values of small intestinal mucosa microcirculation blood flow in group S were higher than those in group C （P 〈 0.05）. Gases analysis of femoral artery blood samples revealed that both the values of pH and BE in group S were higher than those in group C at 60 rain after blood re-transfusion （P 〈 0.05）. However, compared to superior mesenteric vein blood samples＇gases analysis in the group C, the values of pH in group C at 30 and 60 rain were higher and those of BE at 10, 30 and 60 min were higher. Conclusion Scopolamine can improve the small intestinal mucosa microcirculation blood flow to clean the accumulating acidoid during hemorrhage shock/resuscitation process.