低压复苏治疗未控制性出血性休克的作用  

Study on the significance of hypotensive fluid resuscitation from Uncontrolled Hemorrhagic Shock

作　　者：崔恒熙[1] 曹苇[1] 

机构地区：[1]苏州大学附属医院普外科

出　　处：《江苏大学学报（医学版）》2007年第2期152-154,共3页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:通过检测血内皮素和乳酸的动态变化,探讨低压复苏治疗未控制性出血性休克的作用。方法:建立未控制性出血性休克模型,分为低压复苏组和传统复苏组;假休克组作对照组。于休克初期、休克末期、充分复苏结束后和观察期末测定血乳酸和内皮素浓度。结果:(1)低压复苏组和传统复苏组乳酸和内皮素水平较假休克组各时间点明显增高,差异有统计学意义(P<0.05),休克末达到最高水平。(2)休克初期传统复苏组和低压复苏组乳酸和内皮素差异无统计学意义(P>0.05),其他时间段传统复苏组比低压复苏组均明显增高,差异有统计学意义(P<0.05);低压复苏组乳酸和内皮素复苏后下降趋势更明显。结论:低压复苏比传统复苏有更低血乳酸和内皮素水平,而且复苏后下降趋势更明显。提示低压复苏的方法能改善微循环和减轻酸中毒,复苏的效果和预后更好。Objective： To investigate the significance of hypotensive fluid resuscitation from Uncontrolled Hemorrhagic Shock by detecting endothelin and lactate dynamic changes. Methods： Eighteen healthy New Zealand rabbits were randomly assigned to three groups： hypotensive fluid resuscitation, traditional fluid resuscitation, and non-shock control. During the experiments, the arterial blood endothelin and lactate levels were measured at the moments of the start of shock, the end of shock, the end of resuscitation, and the end of observation, respectively. Results： （ 1 ） Compared to the non-shock control group, the blood endothelin and lactate concentrations significantly increased （P 〈 0.05） in the hemorrhagic shock animals during both hypotensive and traditional fluid resuscitation with the peak at the end of shock. （2）There were only slight differences of the endothelin and lactate levels at the start of shock （P 〉 0.05） comparing the hypotensive fluid vs. traditional resuscitation groups. But the hypotensive resuscitated animals showed much lower concentrations （P 〈 0.05） of endothelin and lactate during the following phases of the experiments. Conclusion： According to the lower Endothelin and Lactate levels detected in the group Hypotensive fluid resuscitation, hypotensive fluid resuscitation could improve microcirculation, alleviate acidosis and show the prognostic values in the evaluation of Uncontrolled Hemorrhagic shock resuscitation.

关 键 词：未控制出血性休克 乳酸 内皮素 液体复苏 低血压 

分 类 号：R605.97[医药卫生—急诊医学]