Erbil Y, Seven R, Eminoglu L, Calis A, Gürler N, Olgaç V
Department of Surgery, Istanbul Medical School, Capa, Turkey.
East Afr Med J. 1996 Nov;73(11):699-702.
The aim of this study was to investigate the resuscitative effects of various intravenous solutions on intestinal mucosal damage and bacterial translocation due to haemorrhagic shock. Seventy Sprague-Dawley rats were anaesthetised and subjected to thirty minutes of haemorrhagic shock (systolic blood pressure 40 mmHg). Resuscitation was established with either autologous-blood, three per cent hypertonic saline (HS), 7.5% HS, 0.9% NaCl and Ringer's lactate and Dextran 70 solution. Animals in sham shock group were only cannulated and not resuscitated. Bacterial translocation was evaluated by culture of mesenteric lymph nodes taken 24 hours after resuscitation. The rates of bacterial translocation observed were 50% in autologous blood group, 60% in Dextran 70 group, 40% in Ringer's lactate group, 10% each in 3% HS and 7.5% HS group and 20% in 0.9% NaCl group. A statistically significant difference was observed between the groups resuscitated with HS solution and the other solutions. No meaningful difference was noted between the various concentrations of hypertonic saline solution. The reduction in the rate bacterial translocation with hypertonic solution is assumed to be due to preservation of intestinal microcirculation and thus prevention of intestinal ischaemia.
本研究的目的是探讨各种静脉输液对失血性休克所致肠黏膜损伤和细菌移位的复苏效果。将70只Sprague-Dawley大鼠麻醉后,使其经历30分钟的失血性休克(收缩压40 mmHg)。分别用自体血、3%高渗盐水(HS)、7.5% HS、0.9%氯化钠和乳酸林格液以及右旋糖酐70溶液进行复苏。假休克组动物仅进行插管,不进行复苏。复苏24小时后,通过培养肠系膜淋巴结评估细菌移位情况。观察到的细菌移位率分别为:自体血组50%,右旋糖酐70组60%,乳酸林格液组40%,3% HS组和7.5% HS组各10%,0.9%氯化钠组20%。用HS溶液复苏的组与其他溶液复苏的组之间观察到有统计学意义的差异。不同浓度的高渗盐溶液之间未观察到有意义的差异。高渗溶液使细菌移位率降低被认为是由于维持了肠道微循环,从而预防了肠道缺血。