限制性液体复苏孕兔失血性休克对凝血因子的影响  

Effect of limited fluid resuscitation on blood coagulation factors in pregnant rabbit with hemorrhagic shock

作　　者：龚时鹏[1] 余艳红[1] 陈莉[1] 

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515

出　　处：《中国现代医学杂志》2010年第4期523-525,529,共4页China Journal of Modern Medicine

基　　金：国家自然科学基金(30840089)

摘　　要：目的探讨限制性液体复苏孕兔失血性休克时凝血因子的变化规律。方法制作孕兔失血性休克模型,采取两种不同输液方法复苏孕兔失血性休克,对比研究各组各时间点的PT、APTT、Fbg变化情况。结果孕兔失血性休克会可导致PT、APTT时间延长,Fbg浓度降低。模型第90min、180min、4h限制性输液组与传统输液组相比,PT、APTT、Fbg统计学均有显著差异,P<0.01,且限制性输液组在第4h的Fbg值接近正常水平。结论孕兔失血性休克会后PT、APTT时间延长,Fbg浓度降低。限制性输液能减轻组织供氧不足状态,减少内皮细胞的损害,有效缓解了PT、APTT时间的延长;同时避免了传统输液造成的酸中毒、血液稀释、组织再灌注损伤等不良反应,阻止了Fbg的进一步下降,不失为一种理想的容量复苏方法。【Objective】To investigate the effect of limited fluid resuscitation on blood coagulation factors in pregnant rabbits with hemorrhagic shock. 【Methods】The model of hemorrhagic shock in pregnant rabbit was established. The hemorrhagic shock of pregnant rabbits was resuscitated by adopting different transfusion means. PT, APTT, Fbg change at various time points were compared and studied between the different groups. 【Results】Hemorrhagic shock in pregnant rabbits caused gradual prolongation of APTT and PT and marked reduction of fibrinogen. At 90th min, 180th min, 4th h of the model, tPT, APTT and Fbg were significantly different （P 0.05） between limited fluid group and tradition fluid group; at 4th h of the model, Fbg was normal in limited fluid group.【Conclusion】 Hemorrhagic shock in pregnant rabbits could cause gradual prolongation of APTT and PT and marked reduction of fibrinogen. Limited fluid resuscitation can relieve oxygen deficiency state of tissues, decrease damage of endothelial cells, reduce the prolongation of PT and APTT; at the same time, avoid acidosis, hemodilution and re-perfusion injury of tissues which were seen in tradition fluid resuscitation, prevent marked reduction of fibrinogen. It is an ideal resuscitation means for the hemorrhagic shock in pregnant rabbits.

关 键 词：限制性输液 失血性休克 凝血酶原时间 部分凝血活酶时间 纤维蛋白原 

分 类 号：R749.054[医药卫生—神经病学与精神病学]