【作者】 刘杰；

【导师】 邓跃林；

【作者基本信息】 中南大学 ， 临床医学， 2014， 硕士

【摘要】 目的：观察硝普钠对心肺复苏后大鼠重要脏器微循环血流量的影响,为提高心肺复苏后微循环灌注寻找新的方法。方法：以SD大鼠为实验对象,麻醉、固定、气管插管、股动静脉置管后随机分成假手术组(n=8)、对照组(n=8)和实验组(n=8)。假手术组开胸并于实验开始的Omin、15min和40min分别向左心室内三次注射彩色微球。对照组和实验组采用电刺激心外膜法建立心脏骤停模型,并经心肺复苏达到自主循环恢复,对照组于自主循环恢复后15min开始持续静脉泵入生理盐水4ml/h和5%葡萄糖溶液2ml/h；实验组于自主循环恢复后15min持续静脉泵入生理盐水4ml/h和溶解有硝普钠的5%葡萄糖溶液2ml/h(硝普钠浓度为0.01mg/ml)。实验组和对照组分别于致颤前、自主循环恢复后15min和40min分别开胸左心室内注射彩色微球。第三次微球注射后5min处死大鼠,取心、脑、肾、胃、肠、肺等重要脏器,消化组织并回收微球,通过微球计数间接反映重要脏器微循环血流量的变化情况。结果：1、假手术组三时间点单位重量微球数相比差异无统计学意义(P>0.05)。2、对照组和实验组复苏后15min与致颤前相比,心、脑、肾、胃、肠等脏器单位重量微球数及肺脏单位重量微球数减少(P<0.05)。3、对照组复苏后40min与复苏后15min相比,心、脑、肾、胃、肠、肺等脏器单位重量微球数的比较无统计学差异(P>0.05),实验组复苏后40min与复苏后15min相比心、脑、肾、胃、肠等脏器单位重量微球数增加(P<0.05),肺脏单位重量微球数增加(P<0.05)。结论：1、心脏骤停大鼠经复苏达到自主循环恢复后,心、脑、肾、胃、肠的微循环血流量均减少。2、硝普钠可以改善大鼠心肺复苏后40分钟重要脏器微循环血流量。更多还原

【Abstract】 Object:observing the affect of Sodium nitroprusside on microvascular blood flow of vital organs in a rat model post-cardiopulmonary resuscitation (CPR), in order to find new ways for improving microcirculation perfusion after cardiopulmonary resuscitation (CPR) in rats。Methods:SD rats as experimental subjects, after anesthetizing, fixing, endotracheal intubating and catheterizating of femoral artery and femoral vein, the rats were randomly divided into the sham group (n=8)、control group (n=8) and experimental group (n=8)。Sham group: thoracotomy at the beginning of the experiment and injected colored microspheres into the left ventricle at the time of Omin,15min and40min. Control group and the experimental group was stimulated epicardial by electrical to establish cardiac arrest model, and cardiopulmonary resuscitation was carried out to achieve return of spontaneous circulation, The control group was infused normal saline4ml per hour and5%glucose solution2ml per hour15min after the restoration of spontaneous circulation. Experimental group was infused normal saline4ml per hour and5%glucose solution2ml per hour which soluted sodium nitroprusside15min after restoration of spontaneous circulation (SNP concentration of0.01mg/ml). Before the cause fibrillation,15min and40min after the restoration of spontaneous circulation,experimental group and control group were thoracotomyed and injected colored microspheres into the left ventricle.5min after the third microsphere was injected,rats were killed and heart brain, kidney, stomach, intestines, lungs of the rats was get,tissue was digested and microspheres was recovered to calculate the microcirculatory blood flow in vital organs.Results:1、The number of the microspheres in per gram tissue at three time points of Sham group have no significant differences (P>0.05).2、In the control group and the experimental group,compared with the before fibrillation time,the microspheres in per gram tissue of Heart, brain, kidney, stomach, intestines have significantly decreased at the time of ROSC15min,and the microspheres in per gram tissue of lung have significantly increased(P<0.05).3、In the control group, Compared to the time of ROSC15min, the microspheres in per gram tissue of Heart, brain, kidney, stomach, intestines have no significantly differences at the time of ROSC40min(P>0.05).In the the experimental group, Compared to the time of ROSC15min, the microspheres in per gram tissue of Heart, brain, kidney, stomach, intestines have significantly increased at the time of ROSC40min (P<0.05), and the microspheres in per gram tissue of lung have significantly decreased (P<0.05)Conclusions:1、After cardiac arrest,when rats reach restoration of spontaneous circulation, microcirculation blood flow of heart, brain, kidney, stomach, intestinal was decreased.2、Using sodium nitroprusside can improve the microcirculation blood flow of vital organs in rats after cardiopulmonary resuscitation40minutes.更多还原