Hyperbaric oxygen against stress ulcer in blast-related traumatic brain injury / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of hyperbaric oxygen to reduce stress-induced gastric mucosal injury in rabbits with blast-related brain injury.Methods Posttraumatic stress ulcer in a rabbit model of blast-related brain injury was created using paper detonators.Ninety New Zealand white rabbits were randomly divided into normal control group (n =10),blast-related injury group (n =40) and hyperbaric oxygen treatment group (hyperbaric oxygen group,n =40) according to the random number table.Rabbits in blast-related injury group and hyperbaric oxygen group were subgrouped at 6 hours,24 hours,72 hours and 7 days postinjury,with 10 rabbits at each time point.Gastric mucosal injury was detected in aspects of ulcer index,TUNEL method for apoptotic index,and alcian blue-periodic acid-schiff (AB/PAS) staining and semi-quantitative analysis of pathological histology using.Results Neither stress ulcer nor apoptosis occurred in normal control group.At 6 hours,24 hours,72 hours and 7 days postinjury,index of gastric ulcer in blast-related injury group was 12.08 ± 1.02,25.56 ± 0.88,20.36 ±0.96 and 17.56 ± 1.12 respectively,far higher than 8.02 ±0.58,15.22 ± 1.05,12.39 ±0.65 and 9.22 ± 0.79 in hyperbaric oxygen group (P ＜ 0.05) ; apoptotic index in blast-related injury group was 20.22 ± 1.56,27.56 ± 0.96,24.36 ± 1.23 and 16.38 ± 1.24,far higher than 10.78 ± 0.93,13.89 ±0.84,10.55 ± 1.58 and 8.56 ± 1.47 in hyperbaric oxygen group (P ＜ 0.05).Thickness of AB/PAS-positive mucin layers showed marked attenuation even loss in blast-related injury group,but the loss was minor in hyperbaric oxygen group (P ＜ 0.05).Conclusion Hyperbaric oxygen is effective to decrease the stress ulcer index and apoptosis index of gastric mucosa,increase the thickness of AB/PAS positive layer and lighten the gastric mucosal injury of rabbits with blast-related brain injury.