限制性液体复苏对失血性休克孕兔肾功能的影响  

Effects of Different Means of Fluid Resuscitation on Renal Function of Pregnant Rabbits with Hemorrhagic Shock

作　　者：王晨虹[1] 龚时鹏[2] 余艳红[2] 涂新枝[1] 张铨富[1] 林胜谋[1] 胡冬煦[3] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院妇产科,广东深圳518028 [2]南方医科大学附属南方医院妇产科,广东广州510515 [3]中南大学湘雅二医院胸心外科,湖南长沙410011

出　　处：《医学临床研究》2007年第6期887-889,892,共4页Journal of Clinical Research

基　　金：广东省重大社会问题联合攻关项目基金资助(编号:ZKB04701S)

摘　　要：【目的】探讨不同液体复苏方案对失血性休克孕兔肾功能的影响。【方法】20只孕兔制成未控制性重度失血性休克模型,随机分为假休克组(P组)、休克未处理组(P0组)、限制性液体复苏组(PLH组)、传统液体复苏组(PNL组),对比研究各组各时间点血清肌酐(Cr)的变化情况,并观察孕兔处死后肾脏病理检查结果。【结果】孕兔失血性休克可导致肾小球滤过功能损害,休克时各组的Cr均增高,模型第90 min、180min4、h PLH组血清Cr明显低于PNL组(P<0.05)。P0组肾脏的病理损害最严重,PLH组肾脏病理损害较PNL组明显减轻。但较P组严重。【结论】限制性液体复苏能显著提高肾血液灌注和肾小球滤过率,降低血清Cr含量,改善肾功能,是抢救产科失血性休克的理想复苏方法。【Objective】To investigate the effects of different means of fluid resuscitation on renal function of pregnant rabbits with hemorrhagic shock.【Methods】The model of severe uncontrolled hemorrhagic shock was established in 20 pregnant rabbits.The rabbits were randomly assigned to sham shock group（P group）,untreated group of shock（P0 group）,limited fluid resuscitation group（PLH group） and traditional fluid resuscitation group（PNL group）.The serum Cr change at various time points and renal pathological change were compared and studied among the different groups.【Results】The glomerular filtration function was damaged in pregnant rabbits with hemorrhagic shock,so the contents of serum Cr elevated obviously in all groups.At 90min、180min、4h of the model,the content of serum Cr in PLH group was significantly lower than in PNL group,however was higher than in P group.The renal pathological damage in P0 group was worst among all groups.The renal pathological damage in PLH group was significantly slighter than in PNL group,however was worse than in P group.【Conclusion】Limited fluid resuscitation can obviously increase renal blood flow and glomerular filtration rate,decrease content of serum Cr,improve renal function,which may be an ideal resuscitation means for severe uncontrolled hemorrhagic shock in pregnant women.

关 键 词：休克 出血性 复苏术 妊娠 兔 

分 类 号：R605.971[医药卫生—急诊医学]