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目的 :比较临床常用液体用于创伤失血性休克液体复苏后肺组织损伤程度的影响 ,为创伤失血性休克实施理想的液体复苏治疗提供依据。方法 :比较急性失血大鼠以不同液体复苏后血清细胞因子水平、肺通透性指数变化及肺组织形态学改变。结果 :L R组血清 TNFα,IL- 6水平高于其它各组 ,病理检查肺泡腔渗出液最明显 ,胶体复苏组 BAL F中蛋白含量明显高于晶体组。结论 :急性失血以不同液体复苏后早期即出现程度不同的肺损伤 ;TNFα及 IL - 6是介导此损伤的重要介质 ;大量胶体复苏后肺泡中蛋白渗出显著增加对此类肺损伤的发展不利
OBJECTIVE: To compare the effects of liquid commonly used in clinical practice on the degree of lung injury after fluid resuscitation in traumatic hemorrhagic shock, and to provide a basis for the ideal liquid resuscitation therapy for traumatic hemorrhagic shock. Methods: Serum levels of cytokines, indexes of pulmonary permeability and morphological changes of lungs in acute hemorrhagic rats after resuscitation were compared. Results: Serum levels of TNFα and IL-6 in L R group were higher than those in other groups. The most obvious alveolar exudate in pathological examination was found. The protein content of BAL F in colloid recovery group was significantly higher than that in crystalloid group. CONCLUSIONS: Acute hemorrhage occurs in different stages of early resuscitation, with different degree of lung injury. TNFα and IL - 6 are important mediators of this injury. Excretion of alveolar protein after massive colloid resuscitation significantly increases the development of such lung injury unfavorable