| Objective:It is not clear whether glucocorticoid treatment can improve the outcome of urosepsis caused by upper urinary tract obstruction. The purpose of this study was to investigate the effects of glucocorticoid therapy of differet the start time and dose using the New Zealand rabbit model of septic shock caused by upper urinary tract obstruction.Method:Female New Zealand rabbits were divided into control group(Controll) and experimental group(A1,B1).Then they were given a blood pressure test after the femoral artery puncture, after establishment of infection model of upper urinary tract obstruction model. It was recorded shock time and survival time which were treated with 10mg/kg and 50mg intramuscular injection of hydrocortisone at 1 hour after model establish. The second, Group (control2) and experimental group (A2, B2) were divided into two groups, establish model. Then models were recorded shock time and survival time which were treated with 10mg/kg and 50mg/kg intramuscular injection of hydrocortisone at 1 hour after surgery. The third, experimental subjects Divided into control group (Control3) and experimental group (P3?A3?B3?C3?D3).Recording the time of shock and survival in establishing model before and after 1 hour,2 hours,4 hours and 6 hours for lOmg/kg intramuscular injection of hydrocortisone. All results were statistically analyzed by t test and one-way ANOVA.Results:In the 2 hours after the occurrence of urinary tract obstruction, the Al group average shock time was 11.4+3.3 hours and the mean survival time was 12.8+1.7 hours. At 2 hours after operation, the B1 group average shock time of was 11.2+5.7 hours, and the mean survival time was 21.6+5 hours. Compared with the control group 1, the shock time and survival time were significantly prolonged (P<0.05). There was no significant difference in the time and the death time of 10mg/kg and 50mg/kg in 2 hours after surgery. It is suggested that glucocorticoid can significantly improve the prognosis in the early postoperative period, and there is no significant difference in high dose glucocorticoid. In the 6 hours after the occurrence of urinary tract obstruction, the average shock time was 7.2+1.8 hours and the mean survival time was 15.1+3.18 hours.6 hours after surgery, the average shock time of 50mg/kg was 11.2+5.7 hours, and the mean survival time was 21.6+5.0 hours. Compared with the control group2, there was no significant difference in the survival time.In the upper urinary tract obstruction, there is no significant meaning to the survival time of the glucocorticoid in the late stage of infection. In upper urinary tract infection operation before and after 1 hour, after 2 hours,4 hours, after 6 hours given 10mg/kg of glucocorticoid hormone, the average survival time were 20.2+2.5 hours,19.1+2.9 hours,20.63.4 hours,17.4+ 1.4 hours,12.9+1.4 hours. Among them, P3, A3, B3, C3 group compared with the control group, the survival time was significantly prolonged (P<0.05). Compared with the control group, the survival time of D3 group was not significantly different. Prompt use of low doses of glucocorticoids in the early stage of infection can improve survival outcome. However, the survival time of glucocorticoid was delayed, and the survival time was significantly shortened with the use of glucocorticoids.Conclusion:In summary, there is a significant improvement in the survival outcome to using of hydrocortisone in early time of urosepsis. It is no significant difference between high dose of hydrocortisone and low doses of hydrocortisone to improve the survival outcome. The use of low dose hydrocortisone at the early time of urosepsis should be recommended. |
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