高渗盐羟乙基淀粉液早期复苏兔肺挫伤合并失血性休克对肺组织局部炎症反应的影响.pdfVIP

苏州大学学报(医学版)2008；28(3) 383 高渗盐羟乙基淀粉液早期复苏兔肺挫伤合并失血性休克 对肺组织局部炎症反应的影响 肖接承 ，华 菲 ，沈振亚 ，陆士奇 (苏州大学附属第一医院 1．急诊科，2．心血管外科，江苏苏州 215006) 摘要：目的 观察复方高渗盐溶液(高渗盐羟乙基淀粉液 ，HSH)在兔肺挫伤合并失血性休克早期复苏中对肺组 织肿瘤坏死因子(TNF)一 、白细胞介素(IL一8)含量的影响。方法 建立兔肺损伤合并失血性休克模型后 ，分别用等渗 液(SL酸钠林格平衡液)、高渗液(7．5％生理盐水)、高渗高胶液(75 g／L NaCI+羟乙基淀粉母液)进行复苏治疗，动态观察4 h肺水含量、肺组织TNF— 和IL-8含量及光镜下病理改变。结果 高渗高胶液组的兔肺水含量较另两组有所减轻，而 反映肺组织中炎症反应强弱的TNF— 、IL一8含量也较对照组低，差异有统计学意义(PO．05)。结论 高渗高胶液是目 前用于严重胸部创伤抗休克治疗效果较好的复苏液，对肺组织炎症反应具有一定的抑制作用。 关键词：休克；肺挫伤；高渗；肿瘤坏死因子一 ；白细胞介素一8 中图分类号：R655．3；R364．1+4 文献标识码：A 文章编号：1673—0399(2008)03-0383—03 Effect of Hypertonic Saline-Hydroxyethyl Starch on the Rabbits with the Pulmonary Contusion During Resuscitation from Pulmonary Contusion Combined with Hemorrhagic Shock X／A 0 Jie-cheng ，HUA fei2,SHEN Zhen-．ya2,LU Shi—qi (1．Dept of Eemergency，2．Dept of Cardiovascular Surgery，the First Hospital Affiliated to Suzhou University，Jiangsu Suzhou，2 1 5006，China) Abstract：Objective To study effect of hypertonic saline—hydroxyethyl starch to change of TNF一 and IL一8 on the rabbits with pulmonary contusion combined with hemorrhagic shock． Methods Hemorrhagic shock with pulmonary contusion models were reconstructed 0．9％ 7．5％ saline water and hypedonic saline—hydroxyethyl starch used to treat those rabbits，and dynamic changes of TNF一 ，IL一8，lungs water content and pathological changes were observed for four hours．Results The levels of treated group serum TNF一 ．IL一8 and lungs water content were markedly decreased to the control group．Conclusion Hypertonic saline—hydroxyethyl starch could be used in treatment of hemorrhagic shock with pulmonary contusion and have impact of depress— ing inflammation reaction to lungs．