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通过胃肠道光极测量,双阿司匹林交联血红蛋白在肠道复苏中有效。

Diaspirin cross-linked hemoglobin is efficacious in gut resuscitation as measured by a GI tract optode.

作者信息

Frankel H L, Nguyen H B, Shea-Donohue T, Aiton L A, Ratigan J, Malcolm D S

机构信息

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

出版信息

J Trauma. 1996 Feb;40(2):231-40; discussion 241. doi: 10.1097/00005373-199602000-00010.

Abstract

The objective of this study was to compare the efficacy of diaspirin cross-linked hemoglobin (DCLHb) with that of standard resuscitative fluids in restoring intestinal mucosal oxygenation and villous architecture after hemorrhage. Male rats were bled to a base deficit of 5 +/- 2 nmol/l under propofol anesthesia and monitored for 90 minutes postresuscitation with DCLHb, blood, lactated Ringer's solution, albumin, or nothing (DNR) for mucosal oxygen tension (Pmo2) and physiologic and laboratory parameters. Small intestinal histologic specimens were obtained and scored independently by two investigators blinded to therapy on a scale of 0 (normal) to 4 (worst). All treatments restored Pmo2; only DCLHb did so without exceeding baseline values. For untreated rats (DNR), Pmo2 was not restored. Normal mucosal architecture was maintained only in DCLHb-treated rats. As Pmo2 increased, mucosal score improved. In a rat model of controlled hemorrhage, Pmo2 changes measured by an optode correlated with gut histological abnormalities. By these criteria, DCLHb is superior to crystalloid, colloid, and blood in gut resuscitation.

摘要

本研究的目的是比较双阿司匹林交联血红蛋白(DCLHb)与标准复苏液在出血后恢复肠黏膜氧合及绒毛结构方面的疗效。雄性大鼠在丙泊酚麻醉下出血至碱缺失为5±2 nmol/L,并在复苏后用DCLHb、血液、乳酸林格氏液、白蛋白进行90分钟监测,或不进行处理(DNR),监测黏膜氧分压(Pmo2)以及生理和实验室参数。获取小肠组织学标本,由两名对治疗不知情的研究人员独立评分,评分范围为0(正常)至4(最差)。所有治疗均使Pmo2恢复;只有DCLHb在不超过基线值的情况下做到了这一点。对于未治疗的大鼠(DNR),Pmo2未恢复。仅在DCLHb治疗的大鼠中维持了正常的黏膜结构。随着Pmo2升高,黏膜评分改善。在控制性出血的大鼠模型中,用氧电极测得的Pmo2变化与肠道组织学异常相关。根据这些标准,在肠道复苏方面,DCLHb优于晶体液、胶体液和血液。

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