腹腔复苏对失血性休克家兔肝脏功能的影响

Effects of peritoneal resuscitation on hepatic function in rabbits with hemorrhagic shock

目的观察腹腔复苏对失血性休克家兔肝脏功能的影响。方法 21只雄性家兔随机分为3组,正常对照组(A组)、常规静脉复苏组(B组)及腹腔复苏组(C组)。B组与C组于10 min内使MAP降至40 mmHg。通过放血或回输血液维持40 mmHg水平60 min后,在20 min内静脉回输放出的血液和2倍于放血量的复方乳酸钠进行液体复苏,并于血液和液体复苏的同时,C组腹腔内注射120 mL临床用透析液,而A组和B组腹腔注入等量生理盐水对照。观察休克前、休克后60 min及液体复苏后60和180 min的ALT和AST活性。复苏3 h后,取肝组织测定干湿重比、MDA和SOD,观察形态学变化。结果 C组ALT和AST值均低于B组(P<0.05),MDA和SOD活性分别低于和高于B组(P<0.05)。C组组织的干湿重比值高于B组(P<0.05);B组形态学损伤较C组更明显。并且C组在复苏180 min后ALT、AST与正常对照组比较结果相近。结论腹腔复苏对失血性休克家兔足量液体复苏后的肝脏功能可能有改善作用。

Objective To investigate the effects of peritoneal resuscitation on liver function in rabbits with hemorrhagic shock. Methods Twenty - one male rabbits were randomly divided into 3 groups： no hemorrhagic shock group （Group A）, conventional resuscitation group （Group B）, and peritoneal resuscitation group （Group C）. Rabbits in Group B and C were exsanguinated until mean blood pressure （MAP） reached 40 mmHg within 10 minutes. MAP was kept at 40 mmHg for 60 minutes prior to resuscitation with shed blood plus double hemorrhage volumes of sodium lactate. Meanwhile, 2.5% clinical dialysis fluid, which was replaced with saline in Group A and B, was intraperitoneally injected in Group C. The alanine aminotransferase （ALT） and asparate aminotransferase （AST） were measured at baseline, 60 minutes after shock, and 60 and 180 minutes after resuscitation. The livers were obtained for assessment of dry/wet weight ratio, malondialdehyde （MDA＇）, superoxide dismutase （SOD）, and the pathological change, 3 hours after resuscitation. Results Significant reduction in ALT, AST and MDA was revealed in Group C, comparing with those in Group B （P 〈 0. 05 ）. Meanwhile, significantly increase of dry/wet weight ratio and SOD was revealed in Group C, comparing with those in Group B （P 〈 0. 05）. Furthermore, more prominent pathological change was observed in Group B, comparing with that in Group C. No significant difference in pathological change was observed between Group A and C. Conclusion Peritoneal resuscitation improves the liver function in rabbits with hemorrhagic shock.