高压氧、山莨菪碱和地塞米松对高原冲击伤大鼠的治疗作用

Therapeutic effects of hyperbaric oxygen,anisodaminum and dexamethasome on blast injury in rats exposed to high altitude

目的探讨高压氧、山莨菪碱和地塞米松对高原冲击伤的治疗作用。方法 SD大鼠清醒状态下置于高原冲击伤实验平台内,减压至海拔3500m维持6h,然后用BST-Ⅰ型生物激波管致伤,冲击波超压峰值为(343.5±4.176)kPa,伤后按下述分组处理:A组为对照组,不给予任何处理,B、C、D为处理组,分别于伤后0.5h和3h给予高压氧(2个标准大气压)、山莨菪碱(1mg/kg)和地塞米松(1mg/kg)、高压氧与山莨菪碱和地塞米松联合应用处理。观察大鼠伤后6h的死亡率、动脉血气变化和肺形态学改变。结果 A、B、C、D组的死亡率分别为40.7%、17.4%、24.0%和14.3%,D组与A组比较差异显著(P<0.05);PaO2分别平均为(65.250±11.311)、(82.286±5.908)、(72.625±11.783)和(85.125±7.322)mmHg,B组、D组与A组比较P<0.01;SaO2分别平均为(90.5±4.840)%、(95.429±1.339)%、(93.625±2.925)%和(95.750±0.661)%,B组、D组与A组比较P<0.01,C组与A组比较P<0.05;肺出血和肺水肿程度,B组、D组与A组比较有所减轻,C组与A组比较有所加重。结论高压氧、山莨菪碱和地塞米松及高压氧与山莨菪碱和地塞米松联合应用对高原冲击伤大鼠的治疗有效,其中以高压氧与山莨菪碱和地塞米松联合应用效果更好。

Objective To investigate the treatment effect of hyperbaric oxygen,anisodaminum and dexamethasone on blast injury at high altitude.Methods Rats at waking state were exposed to 3500m above sea level for 6 hours at an experimental device of high altitude blast injury.Then rats were inflicated with blast injury by a BST-Ⅰ shock tube at the peak pressure of（343.5±4.176）kPa.They were divided into four groups： group A（control group） without receiving any treatment;groups B,C and D（treatment groups） were given hyperbaric oxygen,anisodaminum（1mg/kg） and dexamethasone（1mg/kg）,and combined application of hyperbaric oxygen plus anisodaminum and dexamethasone at 0.5 hours and 3 hours after injury,respectively.Mortality rate,blood gas and pulmonary morphological changes were observed at 6 hours after injury.Results The mortality rates were 40.7%,17.4%,24.0% and 14.3% in groups A,B,C,D,respectively.A significant difference in the mortality rate was observed between group A and D（P0.05）.The levels of PaO2 were（65.250±11.311）,（82.286±5.908）,（72.625±11.783） and（85.125±7.322）mmHg,respectively.There was significant difference in groups B and D as compared with group A（P0.01）.The levels of SaO2 were（90.5±4.840）%,（95.429±1.339）%,（93.625±2.925）% and（95.750±0.661）%,respectively.There was significant difference in group B（P0.01）,C（P0.05） and D（P0.01） as compared with group A.Pulmonary hemorrhage and edema were relieved in groups B and D as compared with group A,but they were exacerbated in groups C as compared with group A.Conclusion Hyperbaric oxygen,anisodaminum and dexamethasone,as well as combined application of hyperbaric oxygen,anisodaminum and decamethasone are effective to treat blast injury exposed to high altitude in rats.Moreover,the combined application of hyperbaric oxygen,anisodaminum and decamethasone is more effective.