不同限制性复苏血压水平对出血未控制性休克家兔动脉血气的影响  

Effects of different blood pressure levels on the arterial blood gas of rabbit with uncontrolled hemorrhagic shock during restrictive resuscitation

作　　者：程峰[1] 王振杰[1] 李磊[1] 窦贺贺[1] 邱兆磊[1] 纪忠[1] 王子岩[1] 

机构地区：[1]蚌埠医学院第一附属医院急诊外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2012年第7期759-761,764,共4页Journal of Bengbu Medical College

摘　　要：目的:观察不同限制性复苏血压水平对出血未控制性休克家兔动脉血气的影响,探讨出血未控制性休克复苏时应维持的理想血压水平。方法:采用Wigger改良法制作出血未控制性休克模型,24只家兔随机分为4组(n=6)。NR组:不复苏组;N50组:复苏维持平均动脉压(mean arterial pressure,MAP)在50 mmHg水平;N60组:复苏维持MAP在60 mmHg水平;N70组:复苏维持MAP在70 mmHg水平;在休克前、休克后0、60、120、150、180、240 min检测动脉血气分析,包括血乳酸、剩余碱、氧分压、二氧化碳分压、pH值等指标。结果:N60组氧分压、二氧化碳分压、乳酸、pH值在各个时间点均优于其他组(P<0.05)。结论:失血性休克家兔在出血未控制前行限制性液体复苏时,维持MAP在60 mmHg对动脉血气的影响较小,提示60 mmHg可能是限制性液体复苏比较理想的MAP水平。Objective： To observe effects of different blood pressure levels on the arterial blood gas of rabbit with uncontrolled hemorrhagic shock during restrictive resuscitation and explore the ideal blood pressure levels for uncontrolling hemorrhagic shock. Methods：Model with uncontrolled hemorrhagic shock was established according to modifed Wigger＇s describtion. Twenty-four rabbits in the model were randomly divided into 4 groups （6 in each group）, noresuscitation （NR） group as control, NS0, N60 and N70 groups with maintaining mean arterial pressure （MAP） at 50,60 and 70 mmHg respectively. The arterial blood gas analysis （ABGA） including lactic acid, base excess, arterial oxygen tension, arterial carbon dioxide tension and potential of hydrogen were detected before shock and at 0, 60,120,150,180 and 240 minutes after shock. Results：The data of ABGA of N60 group were better than those of other groups at all time-points. Conclusions ： During restrictive resuscitation of the rabbits with unconrntrolled hemorrhagic shock, maintaining MAP at 60 mmHg has little effect on their ABGA. The results suggest that MAP at 60 mmHg is suitable level for the restrictive resuscitation.

关 键 词：休克 限制性液体复苏 血气分析 平均动脉压 

分 类 号：R441.9[医药卫生—诊断学]