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目的比较胸部开放伤后胸腔海水与淡水浸泡对肺损伤的作用。方法24只实验犬致胸部开放伤后分成对照组、海水组和淡水组。海水组和淡水组伤后10min内经伤口分别灌入海水和淡水;观察胸部开放伤后0、2、4、6、8h的生命体征,测渗透压、血浆炎症因子变化。伤后8h取肺组织观察病理学和炎症因子变化。结果肺泡通透指数:海水组较淡水组明显升高(P<0.05),淡水组与对照组比较无统计学差异(P>0.05);IL-1β、IL-8:海水组较淡水组升高(P<0.05),淡水组较对照组升高(P<0.05);血管性血友病因子(von Willnbrang factor,vWf):海水组较淡水组、对照组升高(P<0.05),淡水组较对照组无差异。相关分析显示:血浆渗透压与肺泡通透性指数、炎症因子IL-1β、IL-8正相关(P<0.05)。结论海水较淡水对开放伤后肺组织的损伤程度更严重,可能与海水高渗加重肺血管通透性和过度炎症反应有关。
Objective To compare the effect of chest seawater and freshwater immersion on lung injury after open chest injury. Methods Twenty-four dogs were divided into control group, seawater group and freshwater group after open chest injury. The seawater and fresh water were infused into the seawater and fresh water within 10 minutes after the injury. The vital signs, the osmotic pressure and the plasma inflammatory factors at 0, 2, 4, 6 and 8 hours after open chest injury were observed. Take the lung tissue 8h after injury to observe the pathology and inflammatory cytokine changes. Results The alveolar permeability index was significantly higher in the seawater group than in the fresh water group (P <0.05), but there was no significant difference between the fresh water group and the control group (P> 0.05); IL-1β and IL-8: (P <0.05). Compared with the control group, the von Willebrand factor (vWf): seawater group was higher than the fresh water group and the control group (P <0.05) Fresh water group than the control group no difference. Correlation analysis showed that plasma osmolality was positively correlated with alveolar permeability index, inflammatory factors IL-1β and IL-8 (P <0.05). CONCLUSIONS: Fresh seawater has a greater degree of damage to lung tissue after open wounds, which may be related to hyperosmotic increase of pulmonary vascular permeability and excessive inflammatory reaction.