卡巴胆碱对失血性休克犬口服补液时肠黏膜血流量和吸收率的影响

摘要

Objective To investigate the effects of carbachol matching oral fluid resuscitation on intestinal mucosa blood flow (IMBF) and intestinal absorption rate of dogs suffered hemorrhagic shock. Methods Twenty-four hours after a preliminary intubation of carotid artery, jugular vein and jejunum by asepsis, twelve Beagle dogs were subjected to a loss of 40％ total blood volume to establish animal model of hemorrhagic shock. Animals were then divided into oral resuscitation group and carbachol group (6 each) . Dogs in oral resuscitation group were given by gastric tube the glucose-electrolyte solution (GES), which was 3 times volume of blood loss, within 24h after bleeding; while dogs in carbachol group were given GES added carbachol (0.25μg/kg) . The IMBF and intestinal absorption rate of water before hemorrhage (0h) and 2, 4 and 8h after hemorrhage were measured. All the animals were sacrificed at 8h after hemorrhage to record the intestinal GES volume. Results The intestinal absorption rate of water remarkably decreased after hemorrhage in both groups,while in carbachol, group it was obiously higher than that in oral resuscitation group ( P＜0. 05) . The GES volume absorbed by intestine in carbachol group was high than that in oral resuscitation group 8h after hemorrhage ( P＜0.05) . The IMBF decreased significantly in the both groups after hemorrhage, and then increased gradually 2h after hemorrhage. The IMBF in carbachol group was obviously higher than that in oral resuscitation group ( P＜0.05) . Conclusion Carbachol in oral resuscitation with GES can improve intestinal absorption rate of water and GES, and increase IMBF in dogs with 40％ blood loss.%目的 探讨卡巴胆碱对失血性休克犬口服补液时肠黏膜血流量(IMBF)和吸收效率的影响.方法 成年雄性Beagle犬12只,先期无菌手术行颈总动脉、颈外静脉、空肠造口置管,24h后按全身血容量的40%放血制作失血性休克模型.随机将犬分为口服补液组(n=6)和卡巴胆碱组(n=6),失血后24h口服补液组经胃输入3倍于失血量的葡萄糖一电解质溶液(GES),卡巴胆碱组则输入溶有卡巴胆碱(0.25μg/kg)的GES.测定犬失血前(Oh)和失血后2、4、8h的肠黏膜血流量及小肠对水的吸收率.失血8h后处死动物,记录肠道GES吸收总量.结果 伤后两组对水的吸收率均较Oh明显下降,但卡巴胆碱组对水的吸收率显著高于口服补液组(P<0.05).伤后8h卡巴胆碱组肠吸收GES总量高于口服补液组(P<0.05).与失血前比较,各组犬IMBF在失血后均大幅降低(P<0.05).两组IMBF于伤后2h开始恢复,各时间点卡巴胆碱组IMBF恢复程度要大于口服补液组(P<0.05).结论 40%血容量失血后口服补液中加入卡巴胆碱能显著改善肠吸收功能,增加肠黏膜血流量.