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失血性休克液体复苏后肠黏膜屏障功能损伤

[Damage of intestinal mucosal barrier function after fluid resuscitation during hemorrhagic shock].

作者信息

Shimada J

机构信息

Department of Anesthesiology, Fukushima Medical College.

出版信息

Masui. 1996 Jan;45(1):49-58.

PMID:8865725
Abstract

The aim of this study is to evaluate the effects of fluid resuscitation during hemorrhagic shock on bacterial overgrowth, bacterial translocation and intestinal pathology. Thirty male Sprague-Dawley rats were divided into three groups as follows: sham shock (anesthesia and femoral artery catheterization, control) was performed on group C, on group B, blood was withdrawn and maintained at a mean blood pressure of 25 mmHg for 30 min, followed by resuscitation with whole shed blood; and on group L, shock was induced by the same method, followed by resuscitation with the same shed blood volume of lactated Ringer's solution. Rats were sacrificed at 24h postshock, and bacterial cultures of blood, liver, mesenteric lymph node and cecum were obtained for standard bacteriological examinations. Furthermore, histologic examination of the end of the ileum was performed. The results indicate the pathologic mucosal injury, bacterial overgrowth and the high magnitudes of translocation occurred more frequently in group L than in groups C and B. Thus, resuscitation with lactated Ringer's solution alone for hemorrhagic shock induces intestinal histologic damage and bacterial overgrowth and leads to increase bacterial translocation.

摘要

本研究旨在评估失血性休克期间液体复苏对细菌过度生长、细菌移位及肠道病理的影响。将30只雄性Sprague-Dawley大鼠分为以下三组:C组进行假休克(麻醉及股动脉插管,作为对照);B组放血并维持平均血压25 mmHg 30分钟,随后用全血回输进行复苏;L组用相同方法诱导休克,随后用相同失血量的乳酸林格氏液进行复苏。休克后24小时处死大鼠,采集血液、肝脏、肠系膜淋巴结及盲肠的细菌培养物进行标准细菌学检查。此外,对回肠末端进行组织学检查。结果表明,L组比C组和B组更频繁地出现病理性黏膜损伤、细菌过度生长及高程度的细菌移位。因此,仅用乳酸林格氏液对失血性休克进行复苏会导致肠道组织学损伤和细菌过度生长,并导致细菌移位增加。

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