CAJ | 학술논문

目的在用同种异体家兔骨髓脂肪建立脂肪栓塞综合征(FES)动模模型基础上,观察羟乙基淀粉130/0.4、低分子肝素对FES的防治作用.方法将42只家兔随机分3组.对照组予0.8ml/kg骨髓脂肪,从股静脉以0.05ml/min速度注射.羟乙基淀粉130/0.4治疗组在注射骨髓脂肪之前3 h及之后12 h分别静脉滴注30 ml/kg羟乙基淀粉130/0.4.低分子肝素治疗组在注射骨髓脂肪之前3 h及之后12 h分别皮下注射300 U/kg低分子肝素.对3组家兔连续观察24 h,观察计算死亡率,检测存活家兔动脉血氧分压、二氧化碳分压,血浆游离脂肪酸(FFA),行肺组织形态及病理学检查.结果跟对照组比较羟乙基淀粉130/0.4干预治疗组,死亡率降低,动脉血氧分压、二氧化碳分压下降值减小,FFA浓度升高值减小,差异有统计学意义(P＜0.01).跟对照组比较低分子肝素干预治疗组以上指标观察数值变化小,差异无统计学意义(P＞0.05).3组死亡率分别为57%、14%、43%.干预治疗组肺组织病理病变均较对照组减轻,但羟乙基淀粉130/0.4比低分子肝素组减轻更明显.结论羟乙基淀粉130/0.4对脂肪栓塞综合征有较好的预防治疗作用.
목적 재용동충이체가토골수지방건립지방전새종합정(FES)동모모형기출상,관찰간을기정분130/0.4、저분자간소대FES적방치작용.방법 장42지가토수궤분3조.대조조여0.8ml/kg골수지방,종고정맥이0.05ml/min속도주사.간을기정분130/0.4치료조재주사골수지방지전3 h급지후12 h분별정맥적주30 ml/kg간을기정분130/0.4.저분자간소치료조재주사골수지방지전3 h급지후12 h분별피하주사300 U/kg저분자간소.대3조가토련속관찰24 h,관찰계산사망솔,검측존활가토동맥혈양분압、이양화탄분압,혈장유리지방산(FFA),행폐조직형태급병이학검사.결과 근대조조비교간을기정분130/0.4간예치료조,사망솔강저,동맥혈양분압、이양화탄분압하강치감소,FFA농도승고치감소,차이유통계학의의(P＜0.01).근대조조비교저분자간소간예치료조이상지표관찰수치변화소,차이무통계학의의(P＞0.05).3조사망솔분별위57%、14%、43%.간예치료조폐조직병리병변균교대조조감경,단간을기정분130/0.4비저분자간소조감경경명현.결론 간을기정분130/0.4대지방전새종합정유교호적예방치료작용.
Objective On the basis of fat embolism syndrome animal model injected with homologous rabbit bone marrow fat, to observe prevention and treatment of fat embolism syndrome (FES) by hydroxyethyl starch 130/0. 4 and low molecular weight heparin. Methods Forty-two rabbits were divided into three groups. The rabbits in control group were injected with bone marrow fat 0. 8 ml/kg (0. 05 ml/min) via femoral vein. In hydroxyethyl starch 130/0. 4 group, the rabbits were intravenously injected with hydroxyethyl starch 130/0. 4 (30 ml/kg), 3 h before and 12 h after embolism respectively. In low molecular weight heparin group, the rabbits were hypodermically injected with low molecular weight heparin (300 U/kg), 3 h before and 12 h after embolism respectively. After observation for 24 h, mortality rate was calculated, the levels of O2 pressure, CO2 pressure and plasma free fatty acid (FFA) were measured, and morphological and pathological changes of the lung were observed. Results As compared with control group, mortality rate, O2 pressure, CO2 pressure and the increase in FFA were reduced in hydroxyethyl starch 130/0. 4 group ( P ＜0. 01 ). There was no significant difference between low molecular weight heparin group and control group. Mortality rate in three groups was respectively 57％, 14％ and 43％ respectively. The pathological changes of the lung in two experimental groups demonstrated mild injuries than in control group, more significantly in hydroxyethyl starch 130/0. 4 group. Conclusion Hydlroxyethyl starch 130/0. 4 could effectively prevent and treat fat embolism syndrome.