卡巴胆碱对大鼠烫伤休克早期口服补液时胃排空和胃血流量的影响

Effects of carbachol on gastric emptying and gastric blood flow in oral fluid resuscitation of burn shock in rats

目的研究拟胆碱药卡巴胆碱对大鼠烫伤休克早期口服补液时胃排空和胃血流量的影响。方法雄性Wistar大鼠78只,随机分为假烫组(n=6)、单纯烫伤组(单烫组,n=18)、卡巴胆碱组(CAL组,n=18)、葡萄糖-电解质液组(GES组,n=18)和GES+CAL组(GES/CAL组,n=18)。用沸水(100℃,15s)造成大鼠背部35%TBSA烫伤。单烫组不补液;GES和GES/CAL组于伤后0.5h开始按Parkland公式量的半量(即每1%TBSA烧伤补液2ml/kg)分2次、间隔2h口服GES液;CAL和GES/CAL组于伤后0.5h口服CAL(60μg/kg)。烫伤后2、4、6h用激光多普勒血流仪测定胃血流量,酚红法测定胃排空率。结果烫伤后胃排空率和胃血流量显著降低(P<0.05);GES或CAL各组胃排空率和胃血流量均显著回升,明显高于单烫组(P<0.05);GES/CAL组胃排空和胃血流量改善比GES、CAL组更为显著(P<0.05)。结论CAL能显著改善大鼠烫伤休克早期胃排空和胃血流量,提高口服液体复苏的效果。

Objective To observe the effects of carbachol（a cholinergic agent）on gastric emptying and gastric blood flow in resuscitation of early shock with oral administration of glucose-electrolyte solution（GES）in scalded rats.Methods Seventy-eight male Wistar rats were randomly assigned into five groups：shame scald（n=6）,scald without fluid resuscitation（n=18）,scald resuscitated with oral GES alone（n=18）,scald resuscitated with oral carbachol alone（CAL,n=18）,and scald resuscitated with oral carbachol plus GES（GES/CAL,n=18）.About 35% TBSA scalded injury on back of rats was produced with boiling water（100℃,15s）in the latter four groups.GES（2ml/kg,which is equivalent to half volume of fluid infusion in first 24 hour according to Parkland＇ formula）was given twice in two-hour intervals by gavage beginning from 30min after the injury in GES and GES/CAL group.Carbachol（60μg/kg）was gavaged 30min after the injury in CAL and GES/CAL group.The gastric emptying rate was determined by phenol red emptying method and gastric blood flow was measured with laser Doppler at 2h,4h and 6h after the scald injury.Results The gastric emptying was obviously delayed and gastric blood flow was significantly reduced in scald animals compared with those in sham group（P〈0.05）,and they were reversed by resuscitation with either GES or CAL,and significantly promoted in GES/CAL group compared with those in GES or CAL group（P〈0.05）.Conclusion It is indicated that carbachol have an obvious effect in improving gastric emptying and gastric blood flow in oral resuscitation of burn shock with rehydration fluid.