| Objective To explore the possibility and mechanism of the occurrence and development of severe abdominal infection in plateau region as well as abdominal traumatic hemorrhage in the treatment of abdominal external pressure,and to provide a theoretical basis for the clinical treatment of severe abdominal infection in plateau region and abdominal traumatic hemorrhage in the treatment of abdominal external pressure.Methods Test 1: The superior mesenteric artery of experimental used rabbits was selected by operation,and the superior mesenteric artery was cut off at 15 cm from the bifurcation of the superior mesenteric artery and abdominal aorta.It was ligatured at the far end,and the tube was placed at the proximal end and was extracted in vitro.After finishing,abdominal closure was conducted,and the animal models of abdominal traumatic hemorrhage of experimental used rabbits were produced.The animal models were randomly divided into two groups: the simple hemorrhage(P)group and the abdominal external pressure(T)group.The simple hemorrhage(P)group: the bloodletting was conducted by the tube in the superior mesenteric artery,and the blood loss and bleeding speed were recorded,the vital signs of animal were observed,and the survival time was recorded.The abdominal external pressure(T)group: the abdominal external pressure was measured with medical sphygmomanometer,and the same treatment with the simple hemorrhage(P)group was made after sphygmomanometer showed the pressure of 7mmHg.The experiment was carried out in the simulated altitude animal laboratory,the simulation environment was 5500 meters above sea level,temperature-25 ?.Test 2: The experimental used rabbits were randomly divided into 5 groups(A,B,C,D,E groups).Before the experiment,use a needle of suture was sewn on the expected ruptured organ,liver of the experimental rabbits,and the knot was loosened to make the tissue surrounded the suture equivalent to the expected size of wound,The end of the suture was drawn in vitro and marked,and after finishing,abdominal closure was conducted.The animals was continued to be kept for a week,and the next experiment would be further conducted after the blood analysis of the experimental rabbits recovered to normal level.In the experiment,the marked suture waspulled out with force according to the need,which might cause the suture cutting injury on the abdominal organs of the animals.The 5 groups were respectively exerted with the pressure of 0mmHg,3 mmHg,7 mmHg,11 mmHg and 15 mmHg.The variation of inflammatory factors in the blood was detected at 1,2,4 and 6 h respectively before the experiment and after abdominal external pressure,and the levels of inflammation in each group were compared.After 6.5 hours of abdominal external pressure,the liver,kidney and small intestine specimens of the killed rabbits were taken to make pathological observation and compare the pathological changes in each group of specimen.The experiment was carried out in the simulated altitude animal laboratory,the simulation environment was 5500 meters above sea level,temperature-25 ?.Test 3: An animal model of severe abdominal infection in rabbits was made by operation and were randomly divided into two groups.The experimental rabbits were made into the closed abdominal trauma animal model of intestinal rupture caused by suture cutting by operation.The rabbits were fasted for 8 h before operation.After anesthesia,the abdomen was cut from the middle,and 1/3 of the circumference of the small intestine was cut at the distance of 15 cm from the ileocecum;the mesenteric intestinal wall was hung in the right side of the abdominal wall with No.1 suture respectively at 1 cm from the top and bottom of the perforation,and the No.1 silk thread was used to close the abdomen in two layers.Control group(P): Only laparotomy was conducted and intestine cutting was not carried out,and the same treatment with the experimental group was done.Before the operation,the blood of the experimental rabbits in the two groups was taken to detect the number of white blood cells and the level of inflammatory factors in the blood.12,18,24 and 36 hours after the operation,the animals were killed to detect the number of peripheral white blood cells and the level of inflammatory factors and the pathological examination of small intestine.The number of white blood cells and the level of inflammatory factors in the blood before and after operation were compared,and the effect of severe abdominal infection in plateau environment on the inflammatory response of organism was learned.All the experiments were finished in the simulated altitude animal laboratory.test group(T): simulated environment is 5500 meters above sea level,temperature-25 ?.Control group(P): simulation environment is 100 meters above sea level,temperature 25 ?.Results Test 1: In the simple hemorrhage(P)group,the average hemorrhage amount of the rabbits was 61.81±9.12 ml,the average hemorrhage speed was 1.93±0.48ml/min,and the average survival time was 33.45±7.00min;and in the abdominal external pressure(T)group,the average hemorrhage amount was 50.19±10.02 ml,the average hemorrhage speed was 1.06±0.21ml/min,and the average survival time was 47.72±4.48 min.Compared with the two groups,the average hemorrhage amount,the average hemorrhage speed,and the average survival time weresignificantly different,and the difference was statistically significant(P<0.05).Test 2: the levels of the inflammatory factors in the blood of the five groups of rabbits were compared,and the difference between the inflammatory factors in the blood of every two groups of rabbits among three groups,A,B and C was not significant,and there is no statistical significance in the difference.The levels of the inflammatory factors in the blood of rabbits in the two groups,D and E were respectively compared with group A.It was significant statistical significance in the difference(P <0.05).Test 3: The difference of TNF-? and IL-6 in plateau alpine environment Compare with Plain group was significantly difference(P <0.05).Conclusion Through the above experiment we draw the following conclusions:1.In the on-the-spot first aid of abdominal traumatic hemorrhage of experimental??rabbits,the application of abdominal external pressure can significantly reduce the amount of hemorrhage and extend the survival time of animals.,which is worthy further study and discussion.2.In the application of different abdominal pressures in the treatment of abdominal traumatic hemorrhage of experimental ??rabbits in plateau region,theoretically,the higher the pressure is,the less the amount of abdominal hemorrhage,but the over-high pressure increases the incidence of abdominal compartment syndrome.The pressure about 7mmHg can not only effectively reduce the amount of abdominal traumatic hemorrhage,but also reduce the inflammatory response of organism to the minimum,so it is the ideal abdominal external pressure,and it provides guiding significance for clinical reference.3.The abdominal infection occurred earlier,heavier and the levels of inflammatory factors higher in plateau alpine region compared to plain areas,which is worthy further study and discussion. |
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