Restrictive Fluid Resuscitation Uncontrolled Hemorrhagic Shock Rats Of Bowel Mucosa And Plasma TNF-α, IL-2 Influence

Objective: this experiment through uncontrolled hemorrhagic shock animal model, observe different fluid resuscitation foe small intestinal mucosa injury condition and serum level of TNF-a, IL-2 influence, this paper discusses the changes of different fluid resuscitation stuck and inflammatory bowel effects for trauma patients factor by fluid resuscitation provides theoretical basis for the way.Methods: SD rats 55, randomly divided into normal control group (n=10), restricted rehydration group (n =15), conventional rehydration group (n=15), shock group (n=15), the control group animals just doing puncture carotid artery, neck vein, give intubation but not bloodletting 120min, observation. The other three groups of animals arteriovenous intubation from carotid artery after per minute rate of 0.2 mL/is 100 gold, make the MAP in 15 bloodletting within the min reduced to 40 to 45 mmHg, then according to the changes in the blood pressure release or back to lose a few blood to maintain the MAP in 40～45 mmHg 15min uncontrolled hemorrhagic shock, making between animal model. After the success of the manufacturing shock model,limiting rehydration group, conventional rehydration groups were jugular vein input lactic acid ringo 60mmHg and maintain the MAP in liquid, and continue to maintain 90mmHg 30min, and shock groups don't give any liquid, and then after the test group were 60min except with the whole blood lactic acid liquid by pehr 2-1 with the volume of full recovery than before to maintain blood pressure levels in shock, and continued 90% of 60min. Four groups in all 0min,60min and 120min. after the experiment begins by carotid artery 1mL catheter place extraction, inject ordinary pipe, blood 3000r/min centrifugal 5min serum, then take by ELISA were measured serum TNF-a, and IL-2 content, and the recovery, aseptic 120min executed animals from the ileum disc sigmoidectomy, under 5 cm place take ileum 4 cm, saline wash, with 10%, the conventional materials producer formaldehyde fixed, HE dyed, light-microscopy Richard change.Results: this experiment in the control groups outside after starting the experiment 60min serum TNF-a, and IL-2 levels are former were significantly increased (P<0.05), in experimental 120min of TNF-a when shock, and IL-2 level obviously higher than other group (P<0.05), conventional rehydration group than limit rehydration group and the control group (P<0.05), and limit rehydration group of TNF-a flat, and IL-2 than in control group (P<0.05). Intestinal tissue pathology observation results show that BNH small intestinal mucosa control basic normal rats, only a handful of appear nap, other three epithelial mild damage are different degree of injury, the gut injury are the most serious in shock group, microscopically nap on both sides have a cortex and the lamina propria separation, fluff damaged companion lamina propria capillary exposure and increased neutrophils and lamina propria damage, bleeding and ulcers etc, in two fluid resuscitation, limiting rehydration group group bowel mucosa damage was significantly less than conventional rehydration group, microscopically villi top under increasing, and clearance of epithelial under expansion, a few epithelial clearance for fluffy damaged with the lamina propria damage etc, and conventional rehydration group and to limit rehydration group and shock between liquid group. Grading, Chiu's in control group damage level obviously lower than the other three groups (P<0.05), and shock group damage level to the other three groups is obviously higher than (P<0.05), in between two fluid resuscitation and conventional rehydration group of damage levels higher than limit rehydration group (P< 0.05).Conclusion: different fluid resuscitation can effectively reduce uncontrolled hemorrhagic shock rat rat early intestinal tissue damage extent of bowel mucosa, don't and reduce rat systemic inflammation; Restrictive relative fluid resuscitation of the conventional fluid resuscitation uncontrolled hemorrhagic shock rat early intestinal mucosa, and the protection function of the inflammatory response to reduce systemic effect more apparent; This experiment tip: in the uncontrolled hemorrhagic shock restrictive fluid resuscitation after than conventional compared can reduce fluid resuscitation intestinal mucosa function, and can reduce systemic damage the inflammation. This may for post-traumatic intestinal mucosa function protection and prevention of MODS and SIRS, provides new ideas.