不同液体复苏策略对内毒素休克大鼠小肠基本电节律的影响
发布时间：2018-12-15 17:49
【摘要】：目的：观察不同液体复苏策略对内毒素休克大鼠小肠基本电节律的影响。 方法：清洁级SD大鼠60只,雌雄不拘,每组10只,用脂多糖内毒素注射建立大鼠内毒素休克模型,根据液体复苏方法不同随机分成6组：A组(单纯胶体复苏,20-40ml/kg/h,维持目标MAP90mmHg,行高容量液体复苏)；B组(单纯晶体复苏,20-40ml/kg/h,维持目标MAP90mmHg,进行高容量液体复苏)；C组(单纯胶体复苏,10-20ml/kg/h,维持目标MAP60mmHg,行小容量液体复苏)；D组(单纯晶体复苏,10-20ml/kg/h,维持目标MAP60mmHg,进行小容量液体复苏)；E组(阳性对照组,即不进行液体复苏,以血管活性药物维持目标MAP60mmHg);F组(正常对照组,即不实施脂多糖内毒素注射)。大鼠以10%水合氯醛10mg/kg腹腔注射麻醉,股动脉置管行有创血压监测,股静脉置管作为液体复苏通道,行剖腹手术,在空肠上段置入双极银针接生物机能系统动态记录小肠肌电变化。经股静脉以脂多糖内毒素10mg/kg注射建立的内毒素休克模型,分别在休克前、休克后、液体复苏后1小时监测小波指标,观察各组慢波振幅(my)、频率(%)、振幅(%)变异系数变化；取休克前、休克后、液体复苏1小时后的大鼠小肠标本,光镜观察小肠粘膜改变,电镜观察小肠Cajal间质细胞(Interstitial cell of Cajal, ICC)超微结构改变,取复苏1h后大鼠小肠测量干/湿重比。 结果：(1)休克后A、B、C、D组小肠肌电慢波振幅(mv)、频率(次/分)明显较休克前降低,且频率(%)、振幅(%)变异系数明显较休克前增高(P0.05),在液体复苏后,慢波振幅、频率、频率变异系数、振幅变异系数较休克后明显改善(P0.05)。 (2)A、B、C、D、E组休克后慢波振幅(mv)、频率(次/分)低于F组,且频率(%)、振幅(%)变异系数明显高于F组(P0.05)；(3)A、B、C、D组液体复苏后,慢波振幅(my)、频率(次/分)高于E组,频率(%)、振幅(%)变异系数明显低于E组(P0.05)；(4)A、B组与C、D组液体复苏后比较,慢波振幅(mv)、频率(次/分)低于C、D组,且频率(%)、振幅(%)变异系数明显高于C、D组(P0.05)；(5)A组与B组、C组与D组比较,其慢波振幅(mv)、频率(次/分)、频率(%)、振幅(%)变异系数差异无统计学意义(P0.05)；(6)光镜下小肠粘膜病理改变：复苏后1小时,A、B、C、D组大鼠小肠黏膜病理损伤评分明显低于E组,差异有统计学意义(P0.05)；(7)电镜下小肠Cajal细胞超微结构改变：休克后小肠Cajal细胞超微结构损伤明显；复苏后1小时,A、B、C、D组细胞内线粒体肿胀,可见淋巴细胞及中性粒细胞侵润。(8)复苏1小时后,A、B组干湿重比例高于C、D组,(P0.05)有统计学意义。 结论：内毒素休克早期,小肠肌电活动呈现慢波振幅(mv)、频率(次／分)降低、频率(%)、振幅(%)变异系数变化增高；小容量液体复苏(20m1/kg/h)对纠正内毒素休克后大鼠小肠基本电节律紊乱效果优于高容量液体夏苏(40ml/kg/h)；晶体复苏与胶体复苏对小肠基本电节律影响无显著差异。
[Abstract]:Aim: to observe the effect of different fluid resuscitation strategies on the basic electrical rhythm of small intestine in rats with endotoxic shock. Methods: sixty clean grade SD rats, male and female, 10 rats in each group, were injected with lipopolysaccharide endotoxin to establish the rat model of endotoxin shock. According to the method of fluid resuscitation, the rats were randomly divided into 6 groups: group A (simple colloid resuscitation); 20-40 ml / kg / h, maintain target MAP90mmHg, for high-volume fluid resuscitation); Group B (single crystal resuscitation, 20-40ml / kg / h, maintaining target MAP90mmHg, for high-volume fluid resuscitation); C group (simple colloid resuscitation, 10-20ml / kg / h, maintaining target MAP60mmHg, for small-volume fluid resuscitation); Group D (simple crystal resuscitation, 10-20 ml / kg / h, maintaining target MAP60mmHg, for small-volume fluid resuscitation); Group E (positive control group, no fluid resuscitation, vasoactive drugs maintained target MAP60mmHg); F group (normal control group, that is, no lipopolysaccharide endotoxin injection). Rats were anesthetized by intraperitoneal injection of 10% chloral hydrate (10mg/kg). Invasive blood pressure monitoring was performed by femoral artery catheterization. Femoral vein catheterization was used as fluid resuscitation channel to perform laparotomy. The electromyoelectric changes of the small intestine were recorded dynamically by the bipolar silver needle attached to the upper jejunum. The endotoxic shock model was established by injection of lipopolysaccharide endotoxin (10mg/kg) through femoral vein. The wavelet indices were monitored before shock, 1 hour after shock and 1 hour after fluid resuscitation, and the (my), frequency of slow wave amplitude (%) was observed in each group. Variation coefficient of amplitude (%); The changes of intestinal mucosa before shock, 1 hour after fluid resuscitation and 1 hour after shock were observed under light microscope, and the ultrastructure of (Interstitial cell of Cajal, ICC) in interstitial cells of Cajal was observed by electron microscope. The dry / wet weight ratio of small intestine was measured 1 hour after resuscitation. Results: (1) the frequency (%) and amplitude (%) variation coefficient of (mv), frequency of small intestinal electromyography slow wave amplitude (mv), / min) in group A (B) C ~ (2 +) after shock were significantly higher than those before shock (P 0.05), and the frequency (%) and amplitude (%) were significantly higher than those before shock (P < 0.05). After fluid resuscitation, the amplitude of slow wave, the coefficient of variation of frequency, and the coefficient of variation of amplitude were significantly improved compared with those after shock (P0.05). (2) the (mv), frequency (times / min) of slow wave amplitude (mv),) after shock was lower in group A than in group F (%) and the coefficient of variation (%) was significantly higher than that in group F (P0.05). (3) after fluid resuscitation, the (my), frequency (times / min) of slow wave amplitude in group D was higher than that in group E (P 0.05), the frequency (%) and the coefficient of variation (%) of amplitude (%) were significantly lower than those in group E (P0.05). (4) after fluid resuscitation, the (mv), frequency of slow wave amplitude in group A B was lower than that in group C D, and the coefficient of variation in frequency (%) and amplitude (%) was significantly higher than that in group C (P 0.05). (5) there was no significant difference in (mv), frequency (times / min), frequency (%) and amplitude (%) variation coefficient between group A and group B and group C and group D (P0.05). (6) pathological changes of intestinal mucosa under light microscope: 1 hour after resuscitation, the pathological injury score of small intestine mucosa in group A BX CnD was significantly lower than that in group E (P0.05); (7) the ultrastructural changes of small intestinal Cajal cells under electron microscope: the damage of small intestinal Cajal cells was obvious after shock; One hour after resuscitation, mitochondria swelling and infiltration of lymphocytes and neutrophils were observed in the mitochondria of group D. (8) after 1 hour of resuscitation, the ratio of dry and wet weight in group A was higher than that in group C (P0.05). Conclusion: in the early stage of endotoxic shock, the electromyoelectric activity of small intestine showed the decrease of (mv), frequency (times / min), the increase of variation coefficient of amplitude (%) and frequency (%). Small volume fluid resuscitation (20m1/kg/h) was more effective than high volume fluid (40ml/kg/h) in correcting the disturbance of basic electrical rhythm of small intestine after endotoxic shock in rats. There was no significant difference between crystal resuscitation and colloidal resuscitation on the basic electrical rhythm of small intestine.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7
本文编号：2381052
[Abstract]:Aim: to observe the effect of different fluid resuscitation strategies on the basic electrical rhythm of small intestine in rats with endotoxic shock. Methods: sixty clean grade SD rats, male and female, 10 rats in each group, were injected with lipopolysaccharide endotoxin to establish the rat model of endotoxin shock. According to the method of fluid resuscitation, the rats were randomly divided into 6 groups: group A (simple colloid resuscitation); 20-40 ml / kg / h, maintain target MAP90mmHg, for high-volume fluid resuscitation); Group B (single crystal resuscitation, 20-40ml / kg / h, maintaining target MAP90mmHg, for high-volume fluid resuscitation); C group (simple colloid resuscitation, 10-20ml / kg / h, maintaining target MAP60mmHg, for small-volume fluid resuscitation); Group D (simple crystal resuscitation, 10-20 ml / kg / h, maintaining target MAP60mmHg, for small-volume fluid resuscitation); Group E (positive control group, no fluid resuscitation, vasoactive drugs maintained target MAP60mmHg); F group (normal control group, that is, no lipopolysaccharide endotoxin injection). Rats were anesthetized by intraperitoneal injection of 10% chloral hydrate (10mg/kg). Invasive blood pressure monitoring was performed by femoral artery catheterization. Femoral vein catheterization was used as fluid resuscitation channel to perform laparotomy. The electromyoelectric changes of the small intestine were recorded dynamically by the bipolar silver needle attached to the upper jejunum. The endotoxic shock model was established by injection of lipopolysaccharide endotoxin (10mg/kg) through femoral vein. The wavelet indices were monitored before shock, 1 hour after shock and 1 hour after fluid resuscitation, and the (my), frequency of slow wave amplitude (%) was observed in each group. Variation coefficient of amplitude (%); The changes of intestinal mucosa before shock, 1 hour after fluid resuscitation and 1 hour after shock were observed under light microscope, and the ultrastructure of (Interstitial cell of Cajal, ICC) in interstitial cells of Cajal was observed by electron microscope. The dry / wet weight ratio of small intestine was measured 1 hour after resuscitation. Results: (1) the frequency (%) and amplitude (%) variation coefficient of (mv), frequency of small intestinal electromyography slow wave amplitude (mv), / min) in group A (B) C ~ (2 +) after shock were significantly higher than those before shock (P 0.05), and the frequency (%) and amplitude (%) were significantly higher than those before shock (P < 0.05). After fluid resuscitation, the amplitude of slow wave, the coefficient of variation of frequency, and the coefficient of variation of amplitude were significantly improved compared with those after shock (P0.05). (2) the (mv), frequency (times / min) of slow wave amplitude (mv),) after shock was lower in group A than in group F (%) and the coefficient of variation (%) was significantly higher than that in group F (P0.05). (3) after fluid resuscitation, the (my), frequency (times / min) of slow wave amplitude in group D was higher than that in group E (P 0.05), the frequency (%) and the coefficient of variation (%) of amplitude (%) were significantly lower than those in group E (P0.05). (4) after fluid resuscitation, the (mv), frequency of slow wave amplitude in group A B was lower than that in group C D, and the coefficient of variation in frequency (%) and amplitude (%) was significantly higher than that in group C (P 0.05). (5) there was no significant difference in (mv), frequency (times / min), frequency (%) and amplitude (%) variation coefficient between group A and group B and group C and group D (P0.05). (6) pathological changes of intestinal mucosa under light microscope: 1 hour after resuscitation, the pathological injury score of small intestine mucosa in group A BX CnD was significantly lower than that in group E (P0.05); (7) the ultrastructural changes of small intestinal Cajal cells under electron microscope: the damage of small intestinal Cajal cells was obvious after shock; One hour after resuscitation, mitochondria swelling and infiltration of lymphocytes and neutrophils were observed in the mitochondria of group D. (8) after 1 hour of resuscitation, the ratio of dry and wet weight in group A was higher than that in group C (P0.05). Conclusion: in the early stage of endotoxic shock, the electromyoelectric activity of small intestine showed the decrease of (mv), frequency (times / min), the increase of variation coefficient of amplitude (%) and frequency (%). Small volume fluid resuscitation (20m1/kg/h) was more effective than high volume fluid (40ml/kg/h) in correcting the disturbance of basic electrical rhythm of small intestine after endotoxic shock in rats. There was no significant difference between crystal resuscitation and colloidal resuscitation on the basic electrical rhythm of small intestine.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7
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