溶液温度对失血性休克兔呼吸功能和酸碱平衡的影响  

Effect of Infusion Fluid Temperature on Respiratory Function and Acid-Base Balance in Hemorrhagic Shock in Rabbits

作　　者：刘玉春[1] 王建荣[1] 马燕兰[1] 苏荣[1] 

机构地区：[1]解放军总医院护理部,北京100853

出　　处：《解放军护理杂志》2004年第6期5-7,26,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：全军"十五"攻关课题 ( 0 1MA12 4)

摘　　要：目的　探讨溶液温度对失血性休克兔呼吸功能和酸碱平衡的影响 ,筛选较为适宜的抗休克补液温度。方法　将实验兔随机分为 4组。假手术组不制作休克模型及液体复苏。温热、常温、低温组复制兔失血性休克模型后 ,给予 3倍失血量的平衡液及自体血复苏 ,液体温度分别控制在 (39.5± 1.3)℃、(2 0 .6± 1.3)℃、(10 .7± 1.6 )℃。选择休克前、休克模型形成后 30min、液体复苏后 1、2和 4h观察呼吸频率、动脉血气指标、血乳酸的变化。结果　液体复苏后 1h ,温热组PaO2 高于常温组及低温组 ,有统计学差异。液体复苏后 4h ,低温组及常温组PaCO2 低于温热组 ,有统计学差异。液体复苏后温热组呼吸较为平稳 ,动脉血 pH、SO2 上升时相较早 ,乳酸下降幅度较大。结论　温热溶液复苏对机体内环境的稳定 ,纠正酸碱失衡有一定意义。Objective To investigate the effects of different temperatures of infusion fluid on respiratory function and acid-base balance in hemorrhagic shock rabbits for the purpose of improving nursing care of hemorrhagic shock patients.Methods We used a previously described animal model of controlled hemorrhagic shock rabbits in this randomized experiment. Thirty rabbits were randomized to a warm fluid infusion group, a ambient-temperature fluid infusion group,a cold fluid infusion group and a sham-operation group. The rabbits were then resuscitated with three times the maximal bleeding volume with Ringer's lactate and their blood loss, respiratory rate and some biochemical metabolic values were measured before shock,during shock and 1 h,2 h and 4 h after fluid infusion respectively.Results PaO 2 was higher at 1 h after fluid infusion in the warm fluid infusion group as compared with the cold fluid infusion and ambient-temperature fluid infusion groups (P<0.05). PaCO 2 was lower at 4 h after fluid infusion in the cold fluid infusion and ambient-temperature fluid infusion groups as compared with the warm fluid infusion group (P<0.05).SaO 2,pH and respiratory rate were recovered earlier or remained more stable in the warm fluid infusion group than that in the other groups. There was a steady downward trend in plasma LAC.Conclusion Our data indicate that warm fluid infusion in the rabbit model of controlled hemorrhagic shock has some beneficial effect on respiratory function and some biochemical metabolic values. In view of this, we should pay more attention to the temperature of fluid infusion in nursing care for patients with hemorrhagic shock.

关 键 词：溶液温度 失血性休克 呼吸功能 酸碱平衡 动脉血气 血乳酸 

分 类 号：R605.971[医药卫生—急诊医学]