CAJ | 학술논문

目的观察早期连续性血液净化对幼猪肠穿孔腹膜炎诱导的全身炎症反应综合征(SIRS)的疗效,旨在探索新生儿肠穿孔腹膜炎治疗的新方法.方法 12只上海种小白猪,体重7～9 kg,雌雄不限.随机分为对照组(n=6)和治疗组(n=6).以盲肠手术穿孔诱导全身炎症反应综合征(SIRS),造模成功后治疗组行连续静脉-静脉血液透析滤过(CVVHDF)8 h.成模后,治疗2、4、8、16 h分别记录二组动物基础状态的心率、呼吸、血压、体温、外周血细胞计数和血气分析,采血检测TNF-α、IL-1β和IL-6含量.结果所有动物经造模后4～6 h内均达SIRS标准.经分组行CVVH-DF 8h后,观察指标有明显变化的是:CVVHDF组的心率、呼吸、血压、血清TNF-α水平均较对照组明显降低(P＜0.05),而血清IL-6在CVVHDF组则较对照组升高(P=0.04).血氧分压、血细胞计数和血清IL-1β水平的变化在二组中无显著性差异.结论本组动物实验的资料显示,在幼猪肠穿孔腹膜炎模型中,治疗的早期采用CVVHDF,可降低部分炎因子反应,对稳定SIRS动物的血流动力学有益处,但对SIRS的部分指标改善不显著.
목적 관찰조기련속성혈액정화대유저장천공복막염유도적전신염증반응종합정(SIRS)적료효,지재탐색신생인장천공복막염치료적신방법.방법 12지상해충소백저,체중7～9 kg,자웅불한.수궤분위대조조(n=6)화치료조(n=6).이맹장수술천공유도전신염증반응종합정(SIRS),조모성공후치료조행련속정맥-정맥혈액투석려과(CVVHDF)8 h.성모후,치료2、4、8、16 h분별기록이조동물기출상태적심솔、호흡、혈압、체온、외주혈세포계수화혈기분석,채혈검측TNF-α、IL-1β화IL-6함량.결과 소유동물경조모후4～6 h내균체SIRS표준.경분조행CVVH-DF 8h후,관찰지표유명현변화적시:CVVHDF조적심솔、호흡、혈압、혈청TNF-α수평균교대조조명현강저(P＜0.05),이혈청IL-6재CVVHDF조칙교대조조승고(P=0.04).혈양분압、혈세포계수화혈청IL-1β수평적변화재이조중무현저성차이.결론 본조동물실험적자료현시,재유저장천공복막염모형중,치료적조기채용CVVHDF,가강저부분염인자반응,대은정SIRS동물적혈류동역학유익처,단대SIRS적부분지표개선불현저.
Objective To investigate the effect of continuous veno-venous hemodialysis filtration (CVVHDF)for systemic inflammatory response syndrome(SIRS)in a piglet enterotomic peritonitis model,in order to explore a nova treatment method for infants with peritonitis induced by enterobrosis.Methods Twelve shanghai white piglets,weighing 7-9Kg which underwent cecumotomy tO induce peritomtis,were randomly divided into control(n=6)and CVVHDF(n=6)groups.After the SIRS was successfully induced by cecum enterotomy,the piglets in CVVHDF group accepted cOntinuous veno-venous hemodialysis filtration for 8 hours.The body temperature,heart rate(HR),blood pressure(BP),central venous pressure,blood gas analysis,CBC,and serum TNF-α,IL-6,IL-1β of both groups were measured at 0,2,4,8 and 16h after CVVHDF initiation.Results All the animals got SIRS in 4-6h after operations.After 8 hours of CVVHDF,the HR,respiratory,BP,and serum TNFa were significantly lower than those in the control group(P＜0.05).But the IL-6 level in serum of CVVHDF group was higher than that in control group(P=0.04).There was no difference of SaO2,CBC and serum IL-1β between two groups.Conclusions The performance of CVVHDF in the early treatment stage of enterotomic peritonitis can decrease partial inflammatory reaction,and iS helpful for improvement of hematodynamic in piglets with SIRS,while the 1evel of partial inflammatory factors in SIRS could still remain abnormal.