创伤失血性休克后腹腔压力升高对机体脏器功能影响的实验研究
创伤；失血性休克；液体复苏；腹腔压力；血管渗透性,,创伤；失血性休克；液体复苏；腹腔压力；血管渗透性,关键词：创伤；失血性休克；液体复苏；腹腔压力；血管渗透性,材料与方法,3方法,结果,讨论,参考文献：
摘要： 目的 探讨创伤失血性休克后大量液体复苏引起腹腔压力升高对机体脏器功能的影响。方法Wistar大鼠32只随机分为腹压0、7、15、20mmHg组共4组；每组分别测动脉压、尿量、肝肾功能、血气分析、小肠、肠系膜组织血管渗透性。结果 当腹腔压力为20mmHg时，动脉压开始显著上升，1小时后下降(P<0.01)；尿量减少(P<0.01)；血pH值进一步下降(P<0.05)；血清ALT、AST和BUN无显著差异；肠系膜渗漏在0mmHg和20mmHg较7mmHg和15mmHg显著增加(P<0.05)，而小肠渗漏在15mmHg时即开始升高。结论 创伤失血性休克2小时后经大量液体复苏，腹腔压力与小肠及肠系膜血管渗漏密切有关；当腹腔压达20mmHg时血流动力学、尿量和血pH值出现显著变化。关键词：创伤；失血性休克；液体复苏；腹腔压力；血管渗透性
Influence of increased intraabdminal pressure on organ function after traumatic hemorrhagic shock
YAO Shangsheng,MA Xiaolin
(Trauma Center,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China)
Abstract： Objective To investigate the effect of increased intraabdominal pressure on organs after traumatic hemorrhagic shock in rats.Methods Thirtytwo Wistar rats were randomly divided into 4 groups according to the level of intraabdominal pressure: 0 mmHg group,7mmHg group,15mmHg group and 20mmHg group.Hepatic and renal functions were detected by automatic biochemistry analyzer,and arterial blood pressure,urine output blood,pH and changes of microvascular permeability of small intestine and mesentery were determined by Evens Blue method.Results When intraabdominal pressure(IAP) was maintained at 20 mmHg for 1 hour,urine volume obviously decreased,and blood pH decreased at 15mmHg of IAP.Arterial blood pressure increased at first then declined markedly after 1 hour,but serum ALT,AST and BUN.Cr did not change obviously.Microvascular permeability of mesentery increased obviously(P<0.05) in 0mmHg and 20mmHg groups as compared to 7mmHg and 15mmHg groups.But microvascular permeability of small intestine began to rise at 15mmHg of IAP.Conclusion Microvascular leakage of small intestine and mesentery are related to IAP in rat of under strenuous fluid resuscitation after traumatic hemorrhagic shock for 2 hours；When IAP was 20mmHg,haemodynamics,urine output and blood pH are significantly aggravated. ......
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