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目的 研究大黄对胃肠粘膜血流灌注的影响。方法 选用激光多普勒血流监测仪和胃肠粘膜内pH(pHi)值作为评估失血性休克动物模型和脓毒症患者胃肠粘膜血流灌注的指标。结果 动物实验显示 :失血性休克大鼠尽管予以充分复苏 ,但胃肠粘膜的血流量仅是对照组的一半 ,给予大黄治疗 (5 0mg/kg)后 ,胃肠粘膜的血流量接近正常对照组 (P <0 0 1VS休克组 )。此外正常大鼠喂服大黄后胃肠粘膜的血流量显著提高 (P <0 0 1VS正常对照组 )。临床研究显示 :脓毒症患者胃和直肠粘膜内pHi明显低于对照组 (P <0 0 0 1)。多器官功能障碍综合征 (MODS)患者 ,其pHi显著低于非MODS患者 (P <0 0 0 1VS治疗前 )。另外 ,大黄对应激性胃粘膜病变有效率达 73%。结论 大黄能提高失血性休克大鼠和危重症患者胃肠粘膜内血流灌注。
Objective To study the effect of rhubarb on blood flow perfusion in gastrointestinal mucosa. Methods Laser Doppler blood flow monitor and pH value of gastrointestinal mucosa were used as indexes to evaluate the blood perfusion of gastrointestinal mucosa in animal models of hemorrhagic shock and sepsis. Results Animal experiments showed that hemorrhagic shock rats were adequately resuscitated, but the blood flow of the gastrointestinal mucosa was only half of the control group. After treatment with rhubarb (50 mg/kg), the blood flow of the gastrointestinal mucosa was similar to the normal control group. (P <0 1 VS shock group). In addition, blood flow of the gastrointestinal mucosa was significantly increased in normal rats fed with rhubarb (P < 0.01 vs. normal control). Clinical studies have shown that the pHi in gastric and rectal mucosa of patients with sepsis is significantly lower than that of the control group (P < 0 01). In patients with multiple organ dysfunction syndrome (MODS), the pHi was significantly lower than that of non-MODS patients (P < 0.01 vs. pretreatment). In addition, the effectiveness of rhubarb on stress gastric mucosal lesions reached 73%. Conclusion Rhubarb can increase blood perfusion in the gastrointestinal mucosa of hemorrhagic shock rats and critically ill patients.