本文關鍵詞： 自體血回收 紅細胞 高原 兔 失血性休克　出處：《桂林醫(yī)學院》2015年碩士論文　論文類型：學位論文

【摘要】：目的:探討自體血回收洗滌紅細胞液對高原兔失血性休克復蘇的影響。方法:40只新西蘭大白兔,采用隨機數(shù)字表法分為4個組(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)。試驗前24小時將4組兔飼養(yǎng)于模擬海拔3500m高度的低壓氧艙內(nèi)。24小時后采用改良的Wiggers法復制失血性休克模型,即經(jīng)股動脈放血至MAP為40mmHg。維持此血壓1小時后,自體血組(Z組)回輸經(jīng)自體血回收機過濾、洗滌后的濃縮紅細胞液和相當于失血量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(T1)、休克1h(T2)、復蘇后1h(T3)、2h(T4)以及復蘇后24h(T5)各時間點的平均動脈壓(MAP)和心率(HR)的變化,分別抽取2ml動脈血離心后測定各時間點的血清TNF-α、IL-6的含量和SOD的活力,同時觀察各組動物的24小時存活率。結果:與對照組(C組)比較,其余三組24小時存活率升高;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)時比較,P、C組T3-4MAP下降;與K組比較,Z組T4時MAP升高(P0.05)。與T0時比較,4組T1-4時HR均升高(P0.05)。與T0時比較,4組動物血清TNF-α和IL-6的含量于休克時(T1)開始升高。與C組相比,P、K、Z組兔血清TNF-α和IL-6的含量于復蘇后1h(T3)達高峰,后逐漸下降,但仍高于T0時水平(P0.05)。而C組動物血清TNF-α、IL-6含量在T1以后各時間點均高于T0時水平及其余各組相應時間點水平。與K組和P組相比,在復蘇后2h(T4),Z組動物血清TNF-α和IL-6的含量顯著降低(P0.05)。與T0時比較,4組動物血清SOD的活力于T2時下降;與T2時比較,P、K、Z組T3-5時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)。結論:在高原失血性休克發(fā)生時,采用自體血回收洗滌紅細胞液進行復蘇,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,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.
【學位授予單位】：桂林醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R614

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