摘要
目的观察早期连续性血液净化对幼猪肠穿孔腹膜炎诱导的全身炎症反应综合征（SIRS）的疗效，旨在探索新生儿肠穿孔腹膜炎治疗的新方法。方法12只上海种小白猪，体重7～9kg，雌雄不限。随机分为对照组（n=6）和治疗组（n=6）。以盲肠手术穿孔诱导全身炎症反应综合征（SIRS），造模成功后治疗组行连续静脉-静脉血液透析滤过（CWHDF）8h。成模后，治疗2、4、8、16h分别记录二组动物基础状态的心率、呼吸、血压、体温、外周血细胞计数和血气分析，采血检测TNF-α、IL-1β和IL-6含量。结果所有动物经造模后446h内均达SIRS标准。经分组行CVVH—DF8h后，观察指标有明显变化的是：CVVHDF组的心率、呼吸、血压、血清TNF-α水平均较对照组明显降低（P〈0．05），而血清IL-6在CWHDF组则较对照组升高（P=0．04）。血氧分压、血细胞计数和血清IL-1β水平的变化在二组中无显著性差异。结论本组动物实验的资料显示，在幼猪肠穿孔腹膜炎模型中，治疗的早期采用CWHDF，可降低部分炎因子反应，对稳定SIRS动物的血流动力学有益处，但对SIRS的部分指标改善不显著。
Objective To investigate the effect of continuous veno-venous hemodialysis filtration （CVVHDF） for systemic inflammatory response syndrome （SIRS） in a piglet enterotomic peritonitis model,in order to explore a nova treatment method for infants with peritonitis induced by enterobrosis. Methods Twelve shanghai white piglets,weighing 7-9Kg which underwent cecumotomy to induce peritonitis, were randomly divided into control（n = 6）and CWHDF（n = 6） groups. After the SIRS was successfully induced by cecum enterotomy, the piglets in CWHDF group accepted continuous veno-venous hemodialysis filtration for 8 hours. The body temperature, heart rate （HR）, blood pressure （BP）, central venous pressure, blood gas analysis, CBC, and serum TNF-β, IL-6, IL-1β of both groups were measured at 0,2,4,8 and 16h after CVVHDF initiation. Results All the animals got SIRS in 4-6h after operations. After 8 hours of CWHDF, the HR, respiratory, BP, and serum TNFαwere significantly lower than those in the control group （P〈0. 05）. But the IL-6 level in serum of CWHDF group was higher than that in control group （P = 0. 04）. There was no difference of SaO2, CBC and serum IL-1β between two groups. Conclusions The performance of CWHDF in the early treatment stage of enterotomic peritonitis can decrease partial inflammatory reaction, and is helpful for improvement of hematodynamic in piglets with SIRS,while the level of partial inflammatory factors in SIRS could still remain abnormal.
出处
《中华小儿外科杂志》
CSCD
北大核心
2009年第2期101-105,共5页
Chinese Journal of Pediatric Surgery
基金
复旦大学211工程资助项目
关键词
血液透析滤过
腹膜炎
肠穿孔
Hemodiafiltration
Peritonistis
Intestinal perforation
