V. O. Krylyuk, G. Y. Tsymbaliuk
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摘要

内源性中毒是由内源性产物的病理生物活性或自然解毒系统功能障碍引起的一个复杂的多组分过程。本文介绍了低血容量性休克背景下腹腔复合损伤模型中缺血-再灌注综合征作为内源性中毒发展加重因素的实验结果。本研究旨在了解缺血再灌注综合征对低血容量性休克背景下腹腔联合损伤模型内源性中毒指标变化的影响。材料与方法。实验对象为80只体重190 ~ 220克的非线性雄性大鼠。实验组在低血容量性休克背景下模拟腹腔缺血再灌注综合征,分析内源性中毒标志物(238、254、260、280波长平均质量分数分子)含量及中毒红细胞指数。使用非参数Mann-Whitney u检验评估对照组与研究组之间差异的概率。结果和讨论。在两下肢应用止血止血带,各研究组EII指标均显著可靠升高。在应用止血带并腹腔外伤和低血容量性休克组,EII指标的升高幅度最大。这些数据证明了缺血再灌注综合征对合并创伤的全身改变发展的增强作用。也有研究表明,止血止血带应用后24小时内源性中毒的表现与腹腔复合损伤并发大量外出血的表现相似。在低血容量性休克背景下腹腔联合损伤模型中,两下肢应用止血止血带2小时可促进内源性中毒的发生,再灌注7天后EII指标和中位质量分子显著升高证实了这一点。
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РОЗВИТОК СИНДРОМУ ЕНДОГЕННОЇ ІНТОКСИКАЦІЇ ЗА УМОВ ПОЄДНАНОЇ ТРАВМИ ОРГАНІВ ЧЕРЕВНОЇ ПОРОЖНИНИ НА ФОНІ ГІПОВОЛЕМІЧНОГО ШОКУ ТА РЕПЕРФУЗІЙНОГО СИНДРОМУ КІНЦІВКИ
Endogenous intoxication is a complicated multicomponent process caused by pathological biological activity of endogenous products or dysfunction of natural detoxification systems. The article presents the results of the experiment on ischemic-reperfusion syndrome as an aggravating factor in the development of endogenous intoxication in the model of combined injury of the abdominal cavity in the background of hypovolemic shock.The aim of the study – to learn the effect of ischemic-reperfusion syndrome on the changes of indicators of endogenous intoxication in the model of combined injury of the abdominal cavity in the background of hypovolemic shock.Materials and Methods. The experiment was conducted on 80 nonlinear male rats weighing 190–220 grams. In experimental groups ischemic-reperfusion syndrome was simulated in combination with trauma of the abdominal cavity in the background of hypovolemic shock and contents of endogenous intoxication markers (molecules of average mass fractions determined at wavelengths of 238, 254, 260 and 280) and the erythrocytes index of intoxication were analyzed. The probability of differences between the control group and the study group was evaluated using non-parametric Mann-Whitney U-test.Results and Discussion. The applications of haemostatic tourniquets on two lower limbs caused a significant reliable increase of EII indicator in all study groups. The maximum increase of EII indicator was in the group where the applications of the tourniquets were combined with the trauma of the abdominal cavity and hypovolemic shock. These data proved the potentiating effect of ischemicreperfusion syndrome on the development of systemic changes in combined trauma. It has also been shown that the manifestation of endogenous intoxication within the first 24 hours after the applications of haemostatic tourniquets is similar to that arising from the combined injury of the abdominal cavity in the background of massive external bleeding.Conclusions. The applications of haemostatic tourniquets to the two lower limbs for two hours enhance the development of endogenous intoxication in the model of combined injury of the abdominal cavity in the background of hypovolemic shock, that was confirmed by significant increase of EII indicator and the median mass molecules seven days after reperfusion.
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