羟乙基淀粉130／0．4、低分子肝素对脂肪栓塞综合征的防治作用  

Prevention and treatment of fat embolism syndrome by hydroxyethyl starch 130/0. 4 and low molecular heparin

作　　者：李亚华[1] 陈刚[1] 赵瑞贞[1] 郝建东[2] 齐向北[2] 

机构地区：[1]河北医科大学第三医院呼吸科,石家庄050051 [2]河北医科大学第三医院骨科,石家庄050051

出　　处：《中华实验外科杂志》2011年第1期98-101,共4页Chinese Journal of Experimental Surgery

基　　金：河北省科技厅支撑计划资助项目（072761499）

摘　　要：目的在用同种异体家兔骨髓脂肪建立脂肪栓塞综合征（FES）动模模型基础上，观察羟乙基淀粉130／0．4、低分子肝素对FES的防治作用。方法将42只家兔随机分3组。对照组予0．8ml／kg骨髓脂肪，从股静脉以0．05ml／min速度注射。羟乙基淀粉130／0．4治疗组在注射骨髓脂肪之前3h及之后12h分别静脉滴注30ml／kg羟乙基淀粉130／0．4。低分子肝素治疗组在注射骨髓脂肪之前3h及之后12h分别皮下注射300U／kg低分子肝素。对3组家兔连续观察24h，观察计算死亡率，检测存活家兔动脉血氧分压、二氧化碳分压，血浆游离脂肪酸（FFA），行肺组织形态及病理学检查。结果跟对照组比较羟乙基淀粉130／0．4干预治疗组，死亡率降低，动脉血氧分压、二氧化碳分压下降值减小，FFA浓度升高值减小，差异有统计学意义（P〈0．01）。跟对照组比较低分子肝素干预治疗组以上指标观察数值变化小，差异无统计学意义（P〉0.05）。3组死亡率分别为57％、14％、43％。干预治疗组肺组织病理病变均较对照组减轻，但羟乙基淀粉130／0．4比低分子肝素组减轻更明显。结论羟乙基淀粉130／0．4对脂肪栓塞综合征有较好的预防治疗作用。Objective On the basis of fat embolism syndrome animal model injected with homologous rabbit bone marrow fat, to observe prevention and treatment of fat embolism syndrome （FES） by hydroxyethyl starch 130/0. 4 and low molecular weight heparin. Methods Forty-two rabbits were divided into three groups. The rabbits in control group were injected with bone marrow fat 0. 8 ml/kg （0.05 ml/min） via femoral vein. In hydroxyethyl starch 130/0. 4 group, the rabbits were intravenously injected with hydroxyethyl starch 130/0. 4 （30 ml/kg）, 3 h before and 12 h after embolism respectively. In low molecular weight heparin group, the rabbits were hypodermically injected with low molecular weight heparin （300 U/kg）, 3 h before and 12 h after embolism respectively. After observation for 24 h, mortality rate was calculated, the levels of 02 pressure, CO2 pressure and plasma free fatty acid （FFA） were measured, and morphological and pathological changes of the lung were observed. Results As compared with control group, mortality rate, O2 pressure, CO2 pressure and the increase in FFA were reduced in hydroxyethyl starch 130/0. 4 group （P 〈 0. 01 ）. There was no significant difference between low molecular weight heparin group and control group. Mortality rate in three groups was respectively 57% , 14% and 43% respectively. The pathological changes of the lung in two experimental groups demonstrated mild injuries than in control group, more significantly in hydroxyethyl starch 130/0.4 group. Conclusion Hydroxyethyl starch 130/0. 4 could effectively prevent and treat fat embolism syndrome.

关 键 词：脂肪栓塞综合征 羟乙基淀粉 低分子肝素 家兔 

分 类 号：R965[医药卫生—药理学] R-332[医药卫生—药学]