【摘要】 目的　对失血性休克应用不同的液体复苏方案 ,探讨其对肠道细菌或内毒素移位的影响。期望找到能保护肠黏膜屏障功能的更好的液体复苏方案。方法　将 33只SD大鼠随机分为 3组 ,制成大鼠失血性休克模型 ,分别应用不同的液体复苏方案 (高渗盐明胶、平衡液、生理盐水 ) ,复苏后 4h取肠系膜淋巴结、肝组织及外周血进行细菌培养 ,改良鲎试验定量测定血浆内毒素含量 ,光镜观察回肠黏膜组织形态。结果　高渗盐明胶组、平衡液组与生理盐水组在肠系膜淋巴结和肝组织细菌移位发生率及血浆内毒素含量方面均有显著性差异 ( P <0 0 1)。 3组外周血细菌培养结果之间有显著性差异 ,P <0 0 5。高渗盐明胶组的回肠黏膜组织形态更接近于正常。结论　高渗盐明胶溶液用于失血性休克的液体复苏能更好地减少肠道细菌或内毒素移位更多还原

【Abstract】 Objective To compare the effectiveness of different kinds of fluid resuscitation on bacterial translocation in hemorrhagic shock rats Methods A total of 33 SD rats were randomly divided into 3 groups Hemorrhagic shock was induced by arterial bleeding to keep mean arterial pressure (MAP) of 4 67～5 33 kPa, which was maintained for 60 minutes The 3 groups were then resuscitated with 3 different fluids (hypertonic saline/gelatin, lactate Ringer’s solution, normal saline) respectively Mesenteric lymph nodes, liver, systemic blood were sent for culture with different media The plasma level of endotoxin was determined with limulus amebocyte lysate test Result Significant difference was found in bacterial translocation in mesenteric lymph nodes and liver, and in plasma endotoxin level (P<0 01) Significant difference was also found in bacterial translocation rate in systemic blood culture(P<0 05) Conclusion Hypertonic saline/gelatin solution used in hemorrhagic shock resuscitation show fewer bacterial translocation in mesenteric lymph nodes, liver, and lower plasma level of endotoxin更多还原