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高渗盐水复苏对严重急性胰腺炎猪模型的有益作用。

Beneficial effect of hypertonic saline resuscitation in a porcine model of severe acute pancreatitis.

机构信息

Department of General Surgery, Nanjing University School of Medicine, Nanjing, China.

出版信息

Pancreas. 2012 Mar;41(2):310-6. doi: 10.1097/MPA.0b013e3182297fec.

Abstract

OBJECTIVE

Hypertonic saline (HTS) solution resuscitation has been used in a variety of clinical settings. The aim of this study was to assess the effect of HTS resuscitation on hemodynamics, systemic oxygenation, and organ damage in a porcine model of severe acute pancreatitis.

METHODS

Eighteen anesthetized and mechanically ventilated pigs were divided into 3 groups: HTS group, lactated Ringer solution (LR) group, and sham-operated group. Severe acute pancreatitis was induced in the first 2 groups by injecting 5% sodium taurocholate into the pancreatic duct, and the investigation period was 12 hours. Hemodynamic parameters, urine output, oxygenation parameters, and serum parameters were recorded consecutively. Finally, histologic examinations of the kidney, intestine, pancreas, and lung were performed.

RESULTS

In the HTS group, cardiac output decreased less significantly compared with the LR group. Furthermore, aspartate aminotransferase, creatinine, and lactate levels increased significantly in all animals with severe acute pancreatitis, but the increasing tendency was slower in the HTS group. Nevertheless, the histopathologic analysis revealed similar injuries of the kidney, intestine, pancreas, and lung between the HTS and LR groups.

CONCLUSIONS

Early administration of HTS generally improves hemodynamics and peripheral oxygenation. Despite these normalized parameters, organ damage could not be diminished to a significant degree during observation.

摘要

目的

高渗盐水(HTS)溶液复苏已在多种临床环境中使用。本研究旨在评估 HTS 复苏对严重急性胰腺炎猪模型中血流动力学、全身氧合和器官损伤的影响。

方法

将 18 只麻醉和机械通气的猪分为 HTS 组、乳酸林格氏液(LR)组和假手术组。通过向胰管内注射 5%牛磺胆酸钠,前两组诱导严重急性胰腺炎,研究期为 12 小时。连续记录血流动力学参数、尿量、氧合参数和血清参数。最后,对肾脏、肠道、胰腺和肺进行组织学检查。

结果

与 LR 组相比,HTS 组的心输出量下降幅度较小。此外,所有严重急性胰腺炎动物的天冬氨酸氨基转移酶、肌酐和乳酸水平均显著升高,但 HTS 组的升高趋势较慢。然而,组织病理学分析显示 HTS 和 LR 组的肾脏、肠道、胰腺和肺的损伤相似。

结论

早期给予 HTS 通常可改善血流动力学和外周氧合。尽管这些参数正常化,但在观察期间,器官损伤仍未显著减轻。

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