口服补液减轻40%血容量失血大鼠肠组织缺血性损伤

The effects of oral rehydration on ischemia injury in gut in 40% blood volume loss in rats

目的:研究口服葡萄糖-电解质液(GES)对大鼠40%血容量失血时肠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,行右颈动脉插管。随机分为3组(n=24):GES对照组(GES),失血性休克组(HS)和失血性休克+口服GES液组(HS+GES)。GES组:不放血,手术后口服GES;HS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。HS+GES组于失血后0.5h、1h和6h分3次给予3倍失血量的GES灌胃。用激光多谱勒血流仪测定失血后2h、4h和24h肠组织血流量(IBF)后,处死动物后取肠组织检测二胺氧化酶(DAO)和Na+-K+-ATP酶活性,测定肠组织含水率(WG),并做病理学检查。结果:HS+GES组IBF和Na-K-ATP酶活性均显著高于HS组(P<0.05),但显著低于GES组(P<0.05);失血各组肠WG显著高于GES组(P<0.05),24h时HS+GES组WG显著低于HS组(P<0.05);HS+GES组24hDAO活性均显著高于HS组(P<0.05),但显著低于GES组(P<0.05);失血后24h病理检查HS+GES组肠组织水肿和充血改变比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IBF,提高Na+-K+-ATP酶和DAO活性,减轻肠组织水肿和缺血性损伤。

Objective：To investigate the effects of oral rehydration with glucose electrolyte solution（GES） on intestinal ischemia injury in 40% blood volume loss in rats.Methods：SD rats were randomly divided into three groups（n=24）：oral rehydration without hemorrhage （GES）,hemorrhage without oral rehydration（HS）,hemorrhage resuscitated with oral GES（HS＋GES）.About 4% of total blood volume was bled from the right common carotid artery of rats to produce a model of hemorrhagic shock.GES,which volume was three times of blood loss was given to GES group and HS＋GES group in 0.5 h,1 h and 6 h by a gastric tube post bleeding.The intestinal blood flow（IBF） were measured by laser Doppler at 2 h,4 h and 24 h post hemorrhage.Animals were sacrificed,and specimens of intestinal tissue was taken for evaluation of Na^＋-K^＋-ATPase,diamine oxidase（DAO） and the rate of tissue water content,and assessment of the intestinal pathological changes.Results：The IBF and the activity of Na^＋-K^＋-ATPase in HS＋GES group were dramatically higher than those in HS group（P〈0.05）,and lower than those in GES group（P〈0.05）.The water content of intestinal tissue in HS group were dramatically higher than those in GES group（P〈0.05）,and lower than those at 2 h and 4 h,but dramatically higher than those at 24 h in HS＋GES group.The activity of DAO at 24 h in HS＋GES group was higher than those in HS group（P〈0.05）,and lower than those in GES group（P〈0.05）.Less edema and hyperemia were found in HS＋GES group than those in HS group at 24 h after bleeding.Conclusion：It is indicated that oral rehydration alleviate edema and ischemia injury in gut by increasing intestinal blood flow and the activity of Na^＋-K^＋-ATPase and DAO in the resuscitation of hemorrhagic shock.