羟乙基淀粉对大耳兔腹部大手术术后微血管清蛋白渗漏的影响

发布时间：2018-07-08 16:51

本文选题：大耳兔 + 羟乙基淀粉　；参考：《肠外与肠内营养》2015年01期

【摘要】：目的:羟乙基淀粉(HES)对大耳兔腹部大手术术后早期肠系膜微血管清蛋白(ALB)渗漏的影响,为防止腹部大手术术后早期微血管ALB渗漏提供理论依据。方法:取大耳兔18只,随机分为对照组、等渗盐水组和HES组。对照组不给予任何干预,后两组均行胃大部切除加胰体尾、脾切除术,术后采用等热量和等氮量营养支持,等渗盐水组术后给予25 ml/(kg·d)等渗盐水,HES组术后给予6%HES(130,0.4)25 ml/(kg·d)。术前和术后48 h检测血清ALB浓度,三组兔术后48 h通过静脉注射异硫氰酸罗丹明B标记的牛血清ALB,在激光共聚焦显微镜下动态观察大耳兔肠系膜微血管ALB渗漏情况,并计算其微血管(ALB)渗透率。结果:三组大耳兔术前血清ALB浓度差异无统计学意义(P0.05)。HES组大耳兔术后48 h血浆ALB浓度明显升高,与等渗盐水组比有显著性差异(P0.05),微血管ALB渗漏明显降低(P0.05)。结论:大耳兔腹部大手术术后早期存在低ALB血症,给予HES可减少早期微血管ALB渗漏,提高术后早期血浆ALB浓度。
[Abstract]:Objective: to study the effect of hydroxyethyl starch (HES) on early mesenteric microvascular albumin (ALB) leakage after abdominal major operation in rabbits and to provide a theoretical basis for preventing early microvascular ALB leakage after major abdominal surgery. Methods: eighteen rabbits were randomly divided into control group, isosmotic saline group and HES group. No intervention was given in the control group. The latter two groups were treated with subtotal gastrectomy, pancreaticotomy, splenectomy, and iso-caloric and iso-nitrogen nutrition after operation. The iso-osmotic saline group was given 6HES (130-0.4) 25 ml/ (kg d). After operation. Serum ALB concentration was measured before and 48 hours after operation. ALB leakage of mesenteric microvessels was observed by intravenous injection of bovine serum ALB labeled with Rhodamine isothiocyanate at 48 hours after operation. The permeability of microvessel (ALB) was calculated. Results: there was no significant difference in serum ALB concentration between the three groups before operation (P0.05). The plasma ALB concentration in HES group was significantly higher than that in the isosmotic saline group 48 hours after operation (P0.05), and the microvascular ALB leakage was significantly decreased (P0.05). Conclusion: low ALB was found in the early stage of abdominal major operation in large ear rabbits. HES could reduce early microvascular ALB leakage and increase plasma ALB concentration in the early postoperative period.
【作者单位】：昆明医科大学第二附属医院干疗外科;
【基金】：国家自然科学基金(81160114)
【分类号】：R965

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