CAJ | 학술논문

目的：研究人工诱导浅低温对创伤性失血性休克兔早期复苏的影响。方法将 SPF级健康新西兰大白兔20只，随机分为2组，浅低温组和常温组，每组10只。予乌拉坦麻醉后，采用肾动脉放血法并行小肠夹伤，建立出血未控制失血性休克兔模型。止血前分别将两组实验动物肛温控制在常温（38℃）或浅低温（34℃），顺序予以限制性液体复苏、止血、常压液体复苏并观察8 h。期间在基础点（BL），休克起始点（T0），T120（T1），T240（T2），T360（T3），T480（T4）共6个时间点检测血清乳酸（LACT）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）浓度，以及终点时存活数、总输液量，并进行分析比较。结果（1）实验终点时，浅低温复苏组存活兔（9/10只，生存时间477 min）较常温复苏组（8/10只，生存时间461 min）稍高，但无统计学意义（P＞0.05）；（2）浅低温组 T1～ T4各时间点的血清乳酸 ALT 、AST 均低于常温组（P＜0.05）。结论创伤性失血性休克早期应用浅低温治疗有利于抑制酸中毒进展及保护肝脏功能，其机制可能与低温能减轻休克导致的缺血再灌注损伤所引起的损害有关。
목적：연구인공유도천저온대창상성실혈성휴극토조기복소적영향。방법장 SPF급건강신서란대백토20지，수궤분위2조，천저온조화상온조，매조10지。여오랍탄마취후，채용신동맥방혈법병행소장협상，건립출혈미공제실혈성휴극토모형。지혈전분별장량조실험동물항온공제재상온（38℃）혹천저온（34℃），순서여이한제성액체복소、지혈、상압액체복소병관찰8 h。기간재기출점（BL），휴극기시점（T0），T120（T1），T240（T2），T360（T3），T480（T4）공6개시간점검측혈청유산（LACT）、병안산안기전이매（ALT）、천문동안산안기전이매（AST）농도，이급종점시존활수、총수액량，병진행분석비교。결과（1）실험종점시，천저온복소조존활토（9/10지，생존시간477 min）교상온복소조（8/10지，생존시간461 min）초고，단무통계학의의（P＞0.05）；（2）천저온조 T1～ T4각시간점적혈청유산 ALT 、AST 균저우상온조（P＜0.05）。결론창상성실혈성휴극조기응용천저온치료유리우억제산중독진전급보호간장공능，기궤제가능여저온능감경휴극도치적결혈재관주손상소인기적손해유관。
Objective To investigate the early outcomes and mechanism of therapeutic mild hypothermia in rabbits suffering severe traumatic uncontrolled hemorrhagic shock . Methods Twenty SPF New Zealand rabbits were randomized into 2 groups:Group 1 (mild hypothermia) ,group 2(normothermia) .With urethane anesthesia ,animals underwent kidney artery catheter inserted and intestinal injuries with hemostat ,then suffered blood withdrawal to create uncontrolled hemorrhage shock models .Rectal temperature was controlled at normothermia (38℃)or mild hypothermia(34℃) ,received limited resuscitation ,hemostasis ,aggressive resuscitation in turn and observed for 8 hours .The animals serum Lactic Acid (LACT ) ,Alanine Aminotransferase (ALT ) ,Aspartate Aminotransferase (AST ) at Base Line (BL) ,T0 ,T1 ,T2 ,T3 ,T4 ,as well as servival and fluid requirement at the end point ,were not-ed . Results (1)At the end of the experment ,survivor in mild hypothermic group (9/10 ,survival time ,477 min) was a little higher than that in the normothermic group (8/10 ,survival time ,461 min) ,but no significantly differ-ence (P<0.05) .(2)From T1~T4 ,serum LACT ,AST ,ALT of group 1 on each time point are lower than group 2 (P<0.05) . Conclusion Traumatic uncontrolled hemorrhagic shock takes advantages from therapeutic mild hy-pothermia on alleviating acidosis and liver function .The mechanism may contribute to mild hypothermia can de-crease the organs'damages by ischemia-reperfusion injury .