不同复苏液体对二次打击致MODS血管内皮细胞损伤研究-中西医结合临床专业论文.docxVIP

— — PAGE 1— 摘 要 不同复苏液体对二次打击致 MODS 血管内皮细胞损伤研究 摘 要 目的 ：研究失血性休克不同液体复苏再二次打击致多脏器功能障碍综合征 (MODS)时血管内皮细胞（ EC）损伤影响。方法： SD 大鼠 84 只,随机分为正常对照 组、生理盐水复苏组、7.5%高渗盐水复苏组、万汶复苏组 4 组，每组 21 只。除正常 对照组腹腔注入等量生理盐水外，其余 3 组 SD 大鼠失血性休克维持 1h，进行不同 液体复苏，复苏成功 30min 后 3 组腹腔注射内毒素。分别在注射内毒素后 24、48、 72h 四组随机取 7 只大老鼠抽取静脉血检测各组 EC 生化指标循环内皮细胞（ CEC）、 一氧化氮（NO）、内皮素(ET-1)。结果：复苏再二次内毒素打击致 MODS 中，CEC 数量生理盐水复苏组最高，对照组最低（P0.05），7.5%高渗复苏组明显低于生理盐 水复苏组(P0.05)。NO 含量以 7.5%高渗复苏组最高，并随时间延长数量逐渐增加， 高于生理盐水复苏组及万汶复苏组（P0.05）。ET-1 含量 7.5%高渗复苏组低于生理 盐水复苏组及万汶复苏组（P0.05）。各检测指标随时间变化无明显改变(P0.05)。 镜下观察 7.5%高渗盐水复苏组脏器标本切片病理改变比生理盐水复苏组轻。结论： 失血性休克不同复苏液体内毒素二次打击致 MODS 血管内皮细胞损伤程度不同， 7.5%高渗盐水复苏具有抗血管内皮细胞损伤作用。同时能够减轻重要脏器损伤，改 善 MODS 预后。 关键词：失血性休克；多脏器功能障碍综合征；循环内皮细胞；一氧化氮；内皮素 新疆医科大学医学硕士学位论文 To study influence of blood vessel endothelium cell of MODS rats which resuscitated by different liquid and shock with the endotoxin again Abstract Objective: To study the influence of blood vessel endothelium cell of MODS rats which resuscitated hemorrhagic shock by different liquid and strike with the endotoxin again. Methods ：84 SD rats were randomly divided into four average groups（n=21） which named Normal conrol group, Resuscitated by 0.9% normal saline group, Resuscitated 7.5% hypertonic saline group and Resuscitated by Hydroxyethyl Starch (130/0.4) group。Beside Normal conrol group abdominal cavity pours into 0.9% normal saline（2ml/100g）, the other three group of SD rats all had been kept hemorrhagic shock for one hour, then resuscitated by different liquid.and after 30 minutes during accomplish anabiosis , the three groups rats were injected into antrum of abdomen with the endotoxin again. After it the blood of vein which was taken out from different 7 rats got randomly from the four groups on 24、48、72h was tested about the level of CEC、 NO、 ET-1. Results: Of the MODS rats which resuscitated hemorrhagic shock by different liquid and strike with the endotoxin again , the CEC quantity of Resuscitated by 0.9% normal saline group is the highest and the contro