不同液體復蘇策略對內(nèi)毒素休克大鼠小腸基本電節(jié)律的影響
發(fā)布時間：2018-12-15 17:49
【摘要】：目的：觀察不同液體復蘇策略對內(nèi)毒素休克大鼠小腸基本電節(jié)律的影響。 方法：清潔級SD大鼠60只,雌雄不拘,每組10只,用脂多糖內(nèi)毒素注射建立大鼠內(nèi)毒素休克模型,根據(jù)液體復蘇方法不同隨機分成6組：A組(單純膠體復蘇,20-40ml/kg/h,維持目標MAP90mmHg,行高容量液體復蘇)；B組(單純晶體復蘇,20-40ml/kg/h,維持目標MAP90mmHg,進行高容量液體復蘇)；C組(單純膠體復蘇,10-20ml/kg/h,維持目標MAP60mmHg,行小容量液體復蘇)；D組(單純晶體復蘇,10-20ml/kg/h,維持目標MAP60mmHg,進行小容量液體復蘇)；E組(陽性對照組,即不進行液體復蘇,以血管活性藥物維持目標MAP60mmHg);F組(正常對照組,即不實施脂多糖內(nèi)毒素注射)。大鼠以10%水合氯醛10mg/kg腹腔注射麻醉,股動脈置管行有創(chuàng)血壓監(jiān)測,股靜脈置管作為液體復蘇通道,行剖腹手術(shù),在空腸上段置入雙極銀針接生物機能系統(tǒng)動態(tài)記錄小腸肌電變化。經(jīng)股靜脈以脂多糖內(nèi)毒素10mg/kg注射建立的內(nèi)毒素休克模型,分別在休克前、休克后、液體復蘇后1小時監(jiān)測小波指標,觀察各組慢波振幅(my)、頻率(%)、振幅(%)變異系數(shù)變化；取休克前、休克后、液體復蘇1小時后的大鼠小腸標本,光鏡觀察小腸粘膜改變,電鏡觀察小腸Cajal間質(zhì)細胞(Interstitial cell of Cajal, ICC)超微結(jié)構(gòu)改變,取復蘇1h后大鼠小腸測量干/濕重比。 結(jié)果：(1)休克后A、B、C、D組小腸肌電慢波振幅(mv)、頻率(次/分)明顯較休克前降低,且頻率(%)、振幅(%)變異系數(shù)明顯較休克前增高(P0.05),在液體復蘇后,慢波振幅、頻率、頻率變異系數(shù)、振幅變異系數(shù)較休克后明顯改善(P0.05)。 (2)A、B、C、D、E組休克后慢波振幅(mv)、頻率(次/分)低于F組,且頻率(%)、振幅(%)變異系數(shù)明顯高于F組(P0.05)；(3)A、B、C、D組液體復蘇后,慢波振幅(my)、頻率(次/分)高于E組,頻率(%)、振幅(%)變異系數(shù)明顯低于E組(P0.05)；(4)A、B組與C、D組液體復蘇后比較,慢波振幅(mv)、頻率(次/分)低于C、D組,且頻率(%)、振幅(%)變異系數(shù)明顯高于C、D組(P0.05)；(5)A組與B組、C組與D組比較,其慢波振幅(mv)、頻率(次/分)、頻率(%)、振幅(%)變異系數(shù)差異無統(tǒng)計學意義(P0.05)；(6)光鏡下小腸粘膜病理改變：復蘇后1小時,A、B、C、D組大鼠小腸黏膜病理損傷評分明顯低于E組,差異有統(tǒng)計學意義(P0.05)；(7)電鏡下小腸Cajal細胞超微結(jié)構(gòu)改變：休克后小腸Cajal細胞超微結(jié)構(gòu)損傷明顯；復蘇后1小時,A、B、C、D組細胞內(nèi)線粒體腫脹,可見淋巴細胞及中性粒細胞侵潤。(8)復蘇1小時后,A、B組干濕重比例高于C、D組,(P0.05)有統(tǒng)計學意義。 結(jié)論：內(nèi)毒素休克早期,小腸肌電活動呈現(xiàn)慢波振幅(mv)、頻率(次／分)降低、頻率(%)、振幅(%)變異系數(shù)變化增高；小容量液體復蘇(20m1/kg/h)對糾正內(nèi)毒素休克后大鼠小腸基本電節(jié)律紊亂效果優(yōu)于高容量液體夏蘇(40ml/kg/h)；晶體復蘇與膠體復蘇對小腸基本電節(jié)律影響無顯著差異。
[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.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7
本文編號：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.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7
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