自体血回收洗涤红细胞液对高原兔失血性休克复苏的影响

发布时间：2018-02-25 20:20

本文关键词： 自体血回收红细胞高原兔失血性休克　出处：《桂林医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:探讨自体血回收洗涤红细胞液对高原兔失血性休克复苏的影响。方法:40只新西兰大白兔,采用随机数字表法分为4个组(n=10):自体血组(Z组)、库血组(K组)、平衡液组(P组)和对照组(C组)。试验前24小时将4组兔饲养于模拟海拔3500m高度的低压氧舱内。24小时后采用改良的Wiggers法复制失血性休克模型,即经股动脉放血至MAP为40mmHg。维持此血压1小时后,自体血组(Z组)回输经自体血回收机过滤、洗涤后的浓缩红细胞液和相当于失血量1.5倍的平衡液;库血组(K组)回输等容失血量的异体血及1.5倍失血量的平衡液;平衡液组(P组)回输相当于3倍失血量的平衡液;对照组(C组)旷置。分别记录休克前(T0)、休克时(T1)、休克1h(T2)、复苏后1h(T3)、2h(T4)以及复苏后24h(T5)各时间点的平均动脉压(MAP)和心率(HR)的变化,分别抽取2ml动脉血离心后测定各时间点的血清TNF-α、IL-6的含量和SOD的活力,同时观察各组动物的24小时存活率。结果:与对照组(C组)比较,其余三组24小时存活率升高;与平衡液组(P组)比较,库血组(K组)、自体血组(Z组)存活率升高;与库血组(K组)比较,自体血组(Z组)存活率升高(P0.05)。与休克前(T0)时比较,P、C组T3-4MAP下降;与K组比较,Z组T4时MAP升高(P0.05)。与T0时比较,4组T1-4时HR均升高(P0.05)。与T0时比较,4组动物血清TNF-α和IL-6的含量于休克时(T1)开始升高。与C组相比,P、K、Z组兔血清TNF-α和IL-6的含量于复苏后1h(T3)达高峰,后逐渐下降,但仍高于T0时水平(P0.05)。而C组动物血清TNF-α、IL-6含量在T1以后各时间点均高于T0时水平及其余各组相应时间点水平。与K组和P组相比,在复苏后2h(T4),Z组动物血清TNF-α和IL-6的含量显著降低(P0.05)。与T0时比较,4组动物血清SOD的活力于T2时下降;与T2时比较,P、K、Z组T3-5时SOD的活力升高;与P组比较,Z组SOD的活力升高;与K组比较,Z组SOD的活力升高(P0.05)。结论:在高原失血性休克发生时,采用自体血回收洗涤红细胞液进行复苏,可以减少TNF-α和IL-6的释放,减轻TNF-α和IL-6对组织器官的损伤,同时,能够增加SOD的活力,减少氧自由基对组织的损伤,起到抗氧化应激作用,从而减轻和延缓高原失血性休克的发生和发展。
[Abstract]:Objective: to study the effect of autologous blood recovery washing red blood cell solution on hemorrhagic shock resuscitation in plateau rabbits. Four groups of rabbits were randomly divided into 4 groups: autologous blood group (group Z), blood storage group (group K), balance liquid group (group P) and control group (group C). The four groups were fed in a hypobaric oxygen chamber at a simulated altitude of 3500m for 24 hours before the trial. The hemorrhagic shock model was induced by modified Wiggers method. After maintaining the blood pressure for 1 hour, the autologous blood group (group Z) was infused back to filter through the autologous blood collector, the concentrated erythrocyte solution after washing and the balance solution equivalent to 1.5 times the amount of blood loss. The isovolumic blood loss of allogeneic blood and 1.5 times of blood loss were reinfused in the blood storage group (K group), and the balance fluid equivalent to 3 times blood loss in the balance liquid group (P group). The changes of mean arterial pressure (MAPP) and heart rate (HRR) were recorded in the control group (group C). The changes of mean arterial pressure (MAPP) and heart rate (HRR) were recorded at different time points: before shock, during shock, 1 hour after shock, 1 hour after resuscitation, 1 hour after resuscitation, 1 hour after resuscitation, 2 h after resuscitation, and 24 h after resuscitation. After 2 ml arterial blood centrifugation, the serum TNF- 伪 IL-6 and the activity of SOD were measured, and the 24 hour survival rate of each group was observed. Results: compared with control group C), the 24 hour survival rate of the other three groups was higher than that of control group. Compared with the control group (P), the survival rate of the blood storage group was higher than that of the control group (P < 0.05), the survival rate of the control group was significantly higher than that of the control group (P < 0.05), and that of the control group was significantly lower than that of the control group (P < 0.05), and that of the control group was lower than that of the control group (P < 0.05), and that of the control group was significantly lower than that of the control group (P < 0.05). Compared with group K, MAP increased at T4 in group Z and HR increased at T1-4 compared with group T0. The contents of TNF- 伪 and IL-6 in serum of rabbits in group C were higher than those in group T0. The contents of TNF- 伪 and IL-6 in rabbits in group C were higher than those in group C. Reached its peak at 1 hour after resuscitation. The levels of TNF- 伪 and IL-6 in group C were higher than those in T0 and other groups at each time point after T1, compared with those in group K and group P. At 2 h after resuscitation, the contents of TNF- 伪 and IL-6 in the serum of rats in the T4 / T4 group were significantly lower than those in the control group (P0), the activity of SOD in the serum of the 4 groups decreased at T2, the activity of SOD increased at T3-5 in group T3-5, and the activity of SOD in group Z increased in comparison with that in group P, compared with that in group T0, the activity of TNF- 伪 and IL-6 in group T4 decreased in comparison with that in group T0. Compared with group K, the activity of SOD in group Z increased P0.05.Conclusion: during hemorrhagic shock at high altitude, the release of TNF- 伪 and IL-6 and the injury of TNF- 伪 and IL-6 to tissues and organs can be reduced by using autologous blood recovery washing red blood cell solution for resuscitation. It can increase the activity of SOD, reduce the damage of oxygen free radical to tissues, play the role of antioxidant stress, so as to alleviate and delay the occurrence and development of hemorrhagic shock at high altitude.
【学位授予单位】：桂林医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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