本文關(guān)鍵詞： 自體血回收 紅細(xì)胞 高原 兔 失血性休克　出處：《桂林醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討自體血回收洗滌紅細(xì)胞液對高原兔失血性休克復(fù)蘇的影響。方法:40只新西蘭大白兔,采用隨機(jī)數(shù)字表法分為4個(gè)組(n=10):自體血組(Z組)、庫血組(K組)、平衡液組(P組)和對照組(C組)。試驗(yàn)前24小時(shí)將4組兔飼養(yǎng)于模擬海拔3500m高度的低壓氧艙內(nèi)。24小時(shí)后采用改良的Wiggers法復(fù)制失血性休克模型,即經(jīng)股動(dòng)脈放血至MAP為40mmHg。維持此血壓1小時(shí)后,自體血組(Z組)回輸經(jīng)自體血回收機(jī)過濾、洗滌后的濃縮紅細(xì)胞液和相當(dāng)于失血量1.5倍的平衡液;庫血組(K組)回輸?shù)热菔а康漠愺w血及1.5倍失血量的平衡液;平衡液組(P組)回輸相當(dāng)于3倍失血量的平衡液;對照組(C組)曠置。分別記錄休克前(T0)、休克時(shí)(T1)、休克1h(T2)、復(fù)蘇后1h(T3)、2h(T4)以及復(fù)蘇后24h(T5)各時(shí)間點(diǎn)的平均動(dòng)脈壓(MAP)和心率(HR)的變化,分別抽取2ml動(dòng)脈血離心后測定各時(shí)間點(diǎn)的血清TNF-α、IL-6的含量和SOD的活力,同時(shí)觀察各組動(dòng)物的24小時(shí)存活率。結(jié)果:與對照組(C組)比較,其余三組24小時(shí)存活率升高;與平衡液組(P組)比較,庫血組(K組)、自體血組(Z組)存活率升高;與庫血組(K組)比較,自體血組(Z組)存活率升高(P0.05)。與休克前(T0)時(shí)比較,P、C組T3-4MAP下降;與K組比較,Z組T4時(shí)MAP升高(P0.05)。與T0時(shí)比較,4組T1-4時(shí)HR均升高(P0.05)。與T0時(shí)比較,4組動(dòng)物血清TNF-α和IL-6的含量于休克時(shí)(T1)開始升高。與C組相比,P、K、Z組兔血清TNF-α和IL-6的含量于復(fù)蘇后1h(T3)達(dá)高峰,后逐漸下降,但仍高于T0時(shí)水平(P0.05)。而C組動(dòng)物血清TNF-α、IL-6含量在T1以后各時(shí)間點(diǎn)均高于T0時(shí)水平及其余各組相應(yīng)時(shí)間點(diǎn)水平。與K組和P組相比,在復(fù)蘇后2h(T4),Z組動(dòng)物血清TNF-α和IL-6的含量顯著降低(P0.05)。與T0時(shí)比較,4組動(dòng)物血清SOD的活力于T2時(shí)下降;與T2時(shí)比較,P、K、Z組T3-5時(shí)SOD的活力升高;與P組比較,Z組SOD的活力升高;與K組比較,Z組SOD的活力升高(P0.05)。結(jié)論:在高原失血性休克發(fā)生時(shí),采用自體血回收洗滌紅細(xì)胞液進(jìn)行復(fù)蘇,可以減少TNF-α和IL-6的釋放,減輕TNF-α和IL-6對組織器官的損傷,同時(shí),能夠增加SOD的活力,減少氧自由基對組織的損傷,起到抗氧化應(yīng)激作用,從而減輕和延緩高原失血性休克的發(fā)生和發(fā)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- 偽 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- 偽 and IL-6 in serum of rabbits in group C were higher than those in group T0. The contents of TNF- 偽 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- 偽 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- 偽 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- 偽 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- 偽 and IL-6 and the injury of TNF- 偽 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.
【學(xué)位授予單位】：桂林醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R614

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