腹腔复苏治疗创伤失血性休克大鼠的实验研究

An Experimental Study on Direct Peritoneal Resuscitation in Treatment of Uncontrolled Trauma-hemorrhagic Shock in Rats

目的:探讨在静脉输液通道无法建立的情况下,单纯腹腔复苏对创伤失血性休克是否有效。方法:40只SD大鼠被随机分为A组(空白对照组)、B组(休克不复苏组,出血+急救期不接受任何治疗)、C组(腹腔复苏组,出血+急救期给予腹腔注射平衡液10ml/100g体重)、D组(静脉输液组,出血+急救期静脉输入平衡液并保持大鼠MAP在60±5mmHg),B、C、D三组大鼠均制备为未控制创伤失血性休克模型,记录各组大鼠的生存时间,比较各组大鼠的生存率,在0、30、90和120min时相点观察比较各组大鼠临床指标、血气分析指标和血清TNF-α。结果:C组大鼠的存活时间较B组明显延长(P<0.05);C组大鼠72h存活率明显高于B组,但低于D组(P<0.05)。C组大鼠的临床复苏指标、血气分析指标均优于B组,但较D组差;C组大鼠血清TNF-α低于B组,高于D组。C组大鼠生存率明显高于B组,低于D组。结论:腹腔复苏治疗创伤失血性休克大鼠是有效的但效果比静脉复苏差。

Objective： To explore whether the direct peritoneal resuscitation is effective in treatment of trauma-hemorrhagic shock when the intravenous resuscitation is not available. Methods： Forty SD rats were randomly divided into four groups： Group A （blank control group）, Group B （shock with no resuscitation group, not given any treatment in bleeding and first aid period）, Group C （peritoneal resuscitation group, injection 10ml/100g Lactated Ringer into the peritoneal in bleeding and first aid period）, Group D （intravenous transfusion group, remain MAP on 60± 5mmHg with the infusion of Lactated Ringer in bleeding and first aid period）. Rat models of uncontrolled hemorrhagic shock were constructed for Group B, C and D using the modified Capone method. The survival time and survival rate of each group were recorded and compared.At 0, 30, 90 and 120 min time point, the clinical indicators of each group were observed and compared, as well as indicators of blood gas and TNF-α in serum. Results： The survival time of Group C was longer than that of Group B, and the survival rate of Group C at 72 h was significantly higher than that of Group B, but lower than Group D （P〈0.05）. The clinical indicators and blood gas analysis indicators of Group C were better than those of Group B but worse than those of Group D. The serum concentration of tumor necrosis factor-α of Group C was below that of Group B. Conclusions： Peritoneal resuscitation of uncontrolled trauma-hemorrhagic shock in rats is effective but the effect is not better than that of intravenous resuscitation.