不同浓度高渗盐水对于失血性休克家兔救治效果的研究  

Comparison on effects of hypertonic saline with different concentration in fluid resuscitation to the rabbit model with uncontrollable hemorrhagic shock

作　　者：康丰娟[1] 马锦华[1] 张银娟[1] 刘喜文[1] 

机构地区：[1]中国人民解放军第四军医大学护理学院,西安710032

出　　处：《中国急救复苏与灾害医学杂志》2015年第6期550-554,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：陕西省自然科学基金资助项目（2013JM4061）

摘　　要：目的研究不同浓度高渗盐水（4．5％与7．5％）对非控制性失血性休克家兔复苏效果影响。方法将32只家兔随机分成4组：假手术组（SHAM组）、休克未治疗组（SWT组）、4．5％盐水复苏组（4．5％组）和7．5％盐水复苏组（7．5％组），每组8只，建立非控制性失血性休克家兔模型，在设定时间内，采用预定方案进行液体复苏，监测不同时间点家兔血流动力学指标（CVP、L^SP、±dp／dtmax），实验结束后统计出血量与输液量。结果①30min时，SWT组、4．5％组与7．5％组各数据两两比较差异无统计学意义，与SHAM组比较，差异均有统计学意义；②60min、90min时，SWT组与4．5％组和7．5％组比较，CVP、LVSP、±dp／dtmax数值明显减小（P〈0．05），4．5％组与7．5％组CVP值相比较没有明显差异；60min时，7．5％组LVSP、±dp／dtmax数值明显大于4．5％组（P〈0．05），两组CVP相比较未见明显差异；90min时，7．5％组LVSP、±dp／dtmax数值略大于4．5％组，但差异无统计学意义；③4．5％组与7．5％组在总输液量以及失血量方面差异无统计学意义，但是失血量均明显低于SWT组（P〈0．05）。结论采用液体复苏可以改善家兔的血流动力学指标，与4．5％高渗盐水相比，7．5％高渗盐水在改善失血性休克心脏功能方面作用更为明显，为失血性休克伤员的现场急救以及临床救治提供了一定的数据支持。Objective To study the effects of hypertonic saline with different concentration （4.5% and 7.5%） in fluid resuscitation on hemodynamic in rabbits. Methods A total of 32 rabbits were randomly divided into four groups - SHAM group, SWT group （shock without treatment）, 4.5% group （resuscitation with 4.5% of hypertonic saline）, and 7.5% group （resuscitation with 7.5% of hypertonic saline）, with eight rabbits in each group. The models of uncontrollable hemorrhagic shock of traumatic rabbits were established after given anesthesia. The fluid was infused in two methods of fluid resuscitation at designed time. The target and the data of hemodynamic were detected at the point of 0 minute, 30 minutes, 60 minutes, and 90 minutes after the models were created. Results 1. At the point of 30 minutes, the data of SWT, 4.5% group, 7.5% group reflected insignificant change （P 〉0.05）, which suggested that the model of uncontrolled hemorrhagic shock was duplicated successfully. 2. At the point of 60 minutes and 90 minutes, comparing with 4.5% group and 7.5% group, it reflected a significant decrease inCVP, LVSP,±dp/dtmax date （P 〈0.05） in SWT group, and no significant difference in CVP between 4.5% group and 7.5% group; at 60 minutes, the data of 7.5% group was significantly higher than 4.5% group （P 〈 0.05）, at 90 minutes, the data of 7.5% group was slightly higher than that of 4.5% group but with no statistical difference （P 〉0.05）. 3. No significant difference was found in infusion and blood loss in either 4.5% or 7.5% group, and blood loss of the two groups was significantly lower than SWT. Conclusion It is considered being effective in improving hemodynamic data of the rabbits in fluid resuscitation; comparing with 4.5% hypertonic saline, 7.5% hypertonic saline reflects a better result in improving hemodynamic data. The experiment furnished a data support for clinical treatment to the uncontrollable hemorrhagic shock.

关 键 词：休克 复苏 高渗盐水 

分 类 号：R441.9[医药卫生—诊断学]