摘要目的 观察低血压复苏对出血未控制的失血性休克鼠肠及肺损伤的影响.方法 16只雄性出血未控制的失血性休克Sprague-Dawley(SD)大鼠随机分成正常血压复苏组(Ⅰ组)及低血压复苏组(Ⅱ组).复苏3 h后,分别比较肠损伤及肺损伤的程度.结果 Ⅰ组肠黏膜绒毛受损率为(33.13±2.17)%,而Ⅱ组为(12.38±1.69)%(P＜0.05);Ⅰ组肠道菌群移位发生率为87.5%(7/8),而Ⅱ组为25.0%(2/8)(P＜0.05);Ⅰ组及Ⅱ组伊文思蓝(EBD)漏出率分别为(3.03±0.28)%和(1.25±0.17)%(P＜0.05),肺通透指数(LPI)分别为0.140±0.018和0.085±0.004(P＜0.05),肺组织髓过氧化物酶(MPO)的浓度分别为(16.4±2.6)u/g和(33.8±2.1)u/g(P＜0.05).结论 低血压复苏可以减轻出血未控制的失血性休克鼠肠道及肺的损伤.

abstractsObjective To investigate the effect of hypotensive resuscitation strategies on the hemorrhagic shock-induced gut and lung injury in an uncontrolled hemorrhagic-shock rat model. Methods Uncontrolled hemorrhagic-shock Sprague-Dawley male rats (n = 16;8 rats per group) were randomly assigned to normotensive resuscitation group ( group Ⅰ ) and hypotensive resuscitation group ( group Ⅱ ). 3h after resuscitation,gut injury and lung injury was assessed. Results The percentage of villous injury in group Ⅰwas ( 33. 13 ± 2. 17 ) %, while it was ( 12. 38 ± 1.69 ) % ( P ＜ 0. 05 ). The incidence of bacterial translocation in both groups was 87.5% (7/8) and 25.0% ( 2/8 ) respectively ( P ＜ 0.05 ). The percentage of Evan' s blue leakage was ( 3.03 ± 0. 28 ) % in group Ⅰ , whereas it was ( 1.25 ± 0. 17 ) % in group Ⅱ ( P ＜0. 05). The lung permeability index in both groups was 0. 140 ± 0. 018 and 0. 085 ± 0. 004 respectively (P＜0.05). Myeloperoxidase (MPO) activity in group Ⅰ was significantly higher than in group Ⅱ,(16.4±2.6) u/gvs(33.8±2.1) u/g(P＜0.05). Conclusion In severe and uncontrolled hemorrhagic shock, hypotensive resuscitation before definitive hemorrhage control is achieved is superior to normotensive resuscitation as it decreases both gut and lung injuries.