3种晶体液复苏对失血性休克大鼠的影响  

Effects of Resuscitation with Three Crystalloid Solutions on Rats with Hemorrhagic Shock

作　　者：范颖楠[1] 冯筑生 张斌[1] 张宁[1] 李俊杰[1] 尹文[1] 

机构地区：[1]第四军医大学西京医院急诊科,西安710032

出　　处：《解放军医药杂志》2016年第4期22-26,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省自然科学基础研究计划项目(2014JM4186);西京医院学科助推计划(XJZT14D10)

摘　　要：目的探讨不同晶体液复苏对失血性休克大鼠的影响。方法雄性SD大鼠40只,随机分为对照组、休克组、生理盐水组、乳酸林格液组和醋酸林格液组,每组8只。生理盐水组、乳酸林格液组和醋酸林格液组放血至平均动脉压（MAP）30~40 mm Hg后维持60 min,分别给予3倍失血量的晶体液进行复苏60 min。记录5组大鼠生理指标直至复苏结束。分别于基础阶段（0 min）、失血阶段（10 min）、休克阶段（70 min）和复苏阶段（130 min）行血气和生化检测,记录各组生存情况。结果休克组和3个液体复苏组失血和休克阶段MAP、p H、红细胞比容（Hct）、碱剩余（BE）低于对照组,休克指数（SI）和乳酸（Lac）高于对照组（P〈0.05）。复苏阶段3个液体复苏组MAP低于对照组,高于休克组,SI高于对照组,低于休克组（P〈0.05）;休克组p H和BE均低于对照组,3个液体复苏组均高于休克组（P〈0.05）;休克组和3个液体复苏组Hct低于对照组,且3个液体复苏组低于休克组（P〈0.05）;休克组和乳酸林格液组Lac高于对照组、生理盐水组和醋酸林格液组（P〈0.05）。失血阶段休克组和3个液体复苏组丙氨酸转氨酶（ALT）均较对照组升高（P〈0.05）。休克阶段和复苏阶段休克组和3个液体复苏组生化指标均较对照组升高（P〈0.05）;复苏阶段3个液体复苏组生化指标低于休克组,乳酸林格液组乳酸脱氢酶（LDH）高于醋酸林格液组,生理盐水组肌酸激酶（CK）高于醋酸林格液组,乳酸林格液组ALT高于生理盐水组和醋酸林格液组（P〈0.05）。3个液体复苏组生存时间均长于休克组（P〈0.05）,醋酸林格液组生存时间长于生理盐水组和乳酸林格液组,但差异无统计学意义（P〉0.05）。结论对于失血性休克进行晶体液复苏时,醋酸林格液相对于生理盐水和乳酸林格液在改善代谢情况、减缓脏器损伤和延长生存时间等方面具有一Objective To investigate effects of resuscitation with different crystalloid solutions on rats with hemorrhagic shock. Methods A total of 40 male SD rats were randomly divided into control group（ n = 8）,shock group（ n = 8）,physiological saline group（ n = 8）,Ringer lactate solution group（ n = 8） and acetated Ringer solution group（ n = 8）. The physiological saline,Ringer lactate solution and acetated Ringer solution groups were exsanguinated until mean arterial pressure（ MAP） dropped to 30-40 mm Hg,and were maintained for 60 min,and then were resuscitated with crystalloid solutions which were threefold of the loss blood volume for 60 min respectively. Physiological indexes were recorded until the end of resuscitation. such as MAP,systolic blood pressure（ SBP） and heart rate（ HR）. Blood gas and biochemical indexes were recorded at the baseline（ 0 min）,blood loss（ 10 min）,shock（ 70 min） and resuscitation（ 130 min） stages,and survival conditions were also recorded in all groups. Results Compared with those in the control group,the values of MAP,hydrogen ion concentration（ p H）,hematocrit（ Hct） and base excess（ BE） were lower,while values of shock index（ SI） and lactic acid（ Lac） were higher in the shock group and the three fluid resuscitation groups at the blood loss and shock stages（ P〈0. 05）. At the resuscitation stage,in the three fluid resuscitation groups,MAP values were lower,while SI values were higher than those in the control group,and MAP values were higher,while SI values were lower than those in the shock group（ P〈0. 05）; p H and BE values in the shock group were lower than those in the control group,while the values in the three fluid resuscitation groups were higher than those in the shock group（ P〈0. 05）; Hct values in the shock and the three fluid resuscitation groups were lower than that in the control group,and the values in three fluid resuscitation groups were lower than that in the shock group（ P〈0. 05）; La

关 键 词：晶体液 复苏 休克 出血性 大鼠 Sprague-Dawley 

分 类 号：R605.971[医药卫生—急诊医学]