海战伤大鼠伤后早期体温及糖耐量变化特点研究

The changes of body temperature and glucose tolerance in early phase of the sea water immersion and Laparotomy in rat

目的 通过观测海战伤大鼠伤后12h复温过程及糖耐量的变化规律,探讨海战伤对复温及血糖代谢的影响.方法 成年雄性SD大鼠,30只,随机分为5组,每组6只.麻醉对照组（C组）腹膜切开缝合组（L组）、腹部开放伤45min组（L45组）、腹部开放合并林格氏液浸泡45min组（L＋R45组）及腹部,开放合并海水浸泡45min组（L＋S45组）,在伤后12h内不同时间点进行体温测量,伤后12h行腹腔注射糖耐量实验（IPGTT）,随后计算各组IPGTT血糖值曲线下面积（AUC）.结果 术前各组大鼠体温、糖耐量无明显差异.术后L＋S45组术后即刻体温最低,复温速度最慢,12h时AUC最高.结论 海战伤能够导致严重低体温以及糖代谢紊乱,可能是海战伤预后不良原因之一.早期封闭伤口、脱离低温高渗环境、改善血糖代谢可能提高海战伤救治效果.

Objective To study the influence of sea water immersion on body temperature and glucose metabolism in rats with laparotomy by observing changes of body temperature and glucose tolerance values in temperature recovery process within 12 hours after injury. Methods 30 male SD rats were divided into 5 groups, the control group （C group）, the laparotomy group （L group）, the laparotomy and exposure in air for 45min group （L45 group）, the laparotomy and ringers solution immersion for 45min group （L＋R45 group） and the laparotomy and sea water immersion for 45min group （L＋S45 group）. The body temperature measurements at different time points and intra peritoneal glucose tolerance tests were performed at 12 hours after operation. Values of Area under curve （AUC） of IPGTY glucose levels were calculated. Results No differences of body temperature and IPGTT values were found among the five groups prior to the operation. The L＋S45 group demonstrated the most profound hypothermia, the slowest temperature recovery process, and the highest AUC values of IPGTT test at 12 hours after operation. Conclusion Sea water immersion and laparotomy may induce severe hypothermia and glucose metabolism abnormality which may be underlying mechanisms of poor outcome. Suture of wound in early stage and keeping away from cold and hyperosmosis environment, and improvement of glucose metabolism may jointly improve the prognosis.