口服补液减轻40％血容量失血大鼠肝组织缺血性损伤

Effects of oral resuscitation on ischemia injury in hepatic tissue in 40 % blood volume loss in rats

目的研究口服葡萄糖-电解质液（GES）液对大鼠40％血容量失血时肝组织缺血性损伤的影响。方法雄性SD大鼠，用氯胺酮-速眠新Ⅱ肌注复合麻醉后，行右侧颈动脉插管。随机分为GES对照组（GES，n=10）、失血性休克组（HS，n=10）和HS＋GES组（n=10）。GES组：不放血，手术后口服GES；HS组和HS＋GES组按全身血容量的40％分两次间隔15min放血制作失血性休克模型。于失血后0．5h、1h和6h分3次给予3倍失血量的GES灌胃。测定失血后2h、4h和24h平均动脉压（MAP）和肝组织血流量（HBF），取血测定血浆谷丙转氨酶（ALT）活性，干湿质量测定肝组织含水率，并做病理学检查。结果失血后24hHS＋GES组MAP和HBF分别比HS组高10．9％和18．O％（P均〈0．05），但比GES组低11．3和14．7％（P〈0．05）。HS＋GES组血ALT失血后各时间点均显著低于HS组（P〈0．01），肝组织含水率失血后24h也显著低于HS组（P〈0．05）。病理检查失血后24hHS＋GES组肝组织水肿和充血也比HS组明显减轻。结论口服GES液能显著增加大鼠失血性休克早期肝组织血流量，减轻肝组织水肿和功能损害。

Objective To investigate the effects of oral resuscitation with glucose electrolyte solution （ GES ） on ischemia injury in hepatic tissue in 40% blood volume loss in rats. Methods SD rats were randomly divided into three groups： oral GES without hemorrhage shock （ GES group,n = 10） , hem- orrhage shock without fluid resuscitation （ HS group, n = 24） and hemorrhage shock resuscitated with oral GES （ HS ＋ GES group, n = 24 ）. About 40% of total blood volume was bled from carotid artery of rats to produce a model of hemorrhagic shock. GES, which volume is three times of blood loss was given third times intragastricely at 0.5 h, 1 h and 6 h post bleeding. The mean arterial pressure （ MAP） and hepatic blood flow （HBF） were measured constantly. Animals were sacrificed at 2 h,4 h and 24 h post hemorrhage, blood samples and specimens of hepatic tissue were taken separately for evaluation of plasma alanine aminotransferase （ALT） and tissue water content, and examination of pathological changes. Results It were showed that MAP and HBF in HS ＋ GES group were 10.9% and 18.0% higher than those in HS group（ P 〈 0.05 ） , but 11.3% and 14.7% lower than GES group（ P 〈 0.05 ） at 24 h after bleeding. The activities of plasma ALT were dramatically lower higher in HS ＋ GES group than those in HS group at all time points （ P 〈 0.01 ）. The rate of hepatic water content in HS ＋ GES group was significantly lower at 24 h post hemorrhage than that in HS group. Less edema and hyperemia in hepatic tissue were also found in HS ＋ GES than those in H group at 24 h after bleeding. Condusion It is indicated that oral rehydration improve ischemia injury in hepatic tissue by increasing regional blood flow and alleviating tissue edema in the resuscitation of hemorrhagic shock.