垂体后叶素对重度未控制失血性休克的复苏效果  

Effect of pituitrin on resuscitation in dogs with severe uncontrolled hemorrhagic shock

作　　者：雷黎明[1] 张继刚[2] 周宁[2] 何绍明[2] 

机构地区：[1]南京医科大学附属南京妇幼保健院麻醉科,江苏省210004 [2]南京解放军第454医院麻醉科

出　　处：《江苏医药》2012年第18期2137-2139,共3页Jiangsu Medical Journal

基　　金：南京军区医学科研课题基金项目(08Z014)

摘　　要：目的观察垂体后叶素对重度未控制失血性休克(UHS)犬的复苏效果。方法重度UHS模型犬24只随机均分为三组:A组泵注垂体后叶素;B组间断推注垂体后叶素0.4u/kg;C组间断推注垂体后叶素0.8u/kg。维持MAP不低于40mm Hg。检测放血前即刻(T0)、放血后1h(T1)、放血后2h(T2)、止血并充分液体复苏后2h(T3)的血气、TNF-α和IL-10,记录出血量、存活率。结果在未控制性失血期,A组的失血量少于B组和C组(P<0.05或P<0.01)。与A、B组比较,C组T2和T3时点的碱剩余(BE)和血乳酸(BL)降低,IL-10升高,TNF-α降低(P<0.05或P<0.01)。B组72-h存活率62.5%,明显低于A、C组的100%(P<0.05)。结论在重度UHS的模型犬,间断静注0.8u/kg的垂体后叶素比泵注和间断静注0.4u/kg的垂体后叶素的复苏效果好。TNF-α和IL-10水平与预后密切相关。Objective To observe the efficacy of pituitrin in resuscitation of dogs with severe uncontrolled hemorrhagic shock （UHS）. Methods After established UHS, 24 dogs were equally randomized into three groups of A （treated with pituitrin infusion）, B （treated with intermittent injection of pituitrin 0. 4 u/kg） and C（treated with intermittent injection of pituitrin 0. 8 u/kg）. The mean arterial blood pressure was maintained at 40 mm Hg or more. The blood gas, TNF-α and IL-10 were examined before bleeding（T0）, at 1 h（T1） and 2 h（T2） after bleeding and 72 h（T3） after hemostasis and fluoid resuscitation. Blood loss and survival rate were recorded. Results During uncontrolled hemorrhagic period, blood loss in group A was more than that in groups of B and C （P〈0. 05 or P〈0. 01）. Compared to groups of A and B, hase excess,blood lactate and TNF-α at T2 and T3 were lowerbut IL-10 was higher in group C（P〈0. 05 or P〈0. 01）. The 72-hour survival rate in group B was 62. 5% ,which was lower than 100% in groups of A and C（P〈0. 05）. Conclusion In dog models with serious UHS, intermittently injecting pituitrin 0. 8 u/kg is more effective than injecting pituitrin 0. 4 u/kg or continuOus pituitrin infusion in resuscitation. TNF-α and IL-10 levels were closely related with prognosis.

关 键 词：失血性休克 垂体后叶素 

分 类 号：R614[医药卫生—麻醉学]