超声造影定量分析失血性休克复苏期肝血流灌注变化的实验研究

发布时间：2018-01-21 02:16

本文关键词： 休克出血性超声检查多普勒彩色造影剂复苏术肝血液灌注微循环疾病模型动物兔　出处：《中国医学影像学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨超声造影(CEUS)定量监测失血性休克(HS)复苏期肝实质血流灌注变化的价值。材料与方法 45只实验兔标号后平均分为5组,其中1组作为正常对照组,其余4组均采用Wiggers改良法建立可逆性HS模型。模型组中1组作为休克组,其余3组采用胶体液(羟乙基淀粉)对动物模型进行复苏治疗,并标号后设定为复苏1 h组、复苏4 h组和复苏24 h组。各组实验兔均采动脉血检测血乳酸(LAC),同时行CEUS检查,生成时间-信号强度曲线(TIC)并进行定量分析。实验结束后处死实验兔,取肝组织进行病理检查。结果与正常对照组比较,休克组到达时间(AT)、达峰时间(TTP)明显延长,峰值强度(PI)、曲线下面积(AUC)减低,差异有统计学意义(P0.05);复苏1 h组PI、AUC增加,AT减低,差异有统计学意义(P0.05);复苏4 h组和24 h组PI、AUC增加,AT、TTP减低,差异无统计学意义(P0.05)。与休克组比较,复苏1 h组PI、AUC增加,AT减低,差异有统计学意义(P0.05);复苏4 h组和24 h组间各参数差异均有统计学意义(P0.05)。结论 CEUS可定量评价HS复苏期肝实质血流灌注的改变,对临床治疗具有一定的参考价值。
[Abstract]:Objective to evaluate the value of quantitative monitoring of hepatic parenchymal blood perfusion in hemorrhagic shock shock (HSH) group by contrast-enhanced ultrasound (CEUs). Materials and methods 45 experimental rabbits were divided into 5 groups after labeling. Group 1 was used as normal control group, the other 4 groups were used to establish reversibility HS model by modified Wiggers method, and group 1 of model group was used as shock group. The other three groups were treated with colloidal solution (hydroxyethyl starch) for resuscitation. Arterial blood was collected to detect lactic acid lactic acid (LA) and CEUS was performed in all experimental rabbits after 4 h resuscitation and 24 h resuscitation. At the end of the experiment, the experimental rabbits were killed and the liver tissues were taken for pathological examination. Results compared with the normal control group, the arrival time of shock group was ATT). The peak time (TTP) was prolonged, the peak intensity was increased, and the area under the curve was decreased. The difference was statistically significant (P 0.05). In the group of 1 h resuscitation, the AUC increased and the AT decreased, and the difference was statistically significant (P 0.05). Compared with shock group, PIU AUC increased in 4 h group and 24 h group, but there was no significant difference (P 0.05). Compared with shock group, the AUC increased in 1 hour group after resuscitation. The level of AT was decreased, the difference was statistically significant (P 0.05). There were significant differences in parameters between 4 h group and 24 h group after resuscitation (P 0.05). Conclusion CEUS can quantitatively evaluate the changes of hepatic parenchyma blood perfusion during HS resuscitation. It has certain reference value for clinical treatment.
【作者单位】：南方医科大学;中国人民解放军广州总医院超声科;
【基金】：全军医学科研“十二五”计划课题项目(CWS12J076) 广东省科技计划项目(2014A020212255) 广东省自然科学基金项目(2016A030313611)
【分类号】：R445.1;R459.7
【正文快照】： 失血性休克(hemorrhagic shock,HS)发生后,为保证脑、心等重要器官血流,肝血流灌注会减低,肝细胞对缺血缺氧敏感,易导致肝功能异常,甚至出现衰竭。液体复苏是抗休克治疗的重要手段[1-2]。为避免器官发生隐匿性缺血,掌握复苏期各器官微循环灌注特征具有重要意义。前期研究显示,

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