脓毒症休克钠钾镁钙葡萄糖液复苏对舌下微循环影响  

EFFECT OF FLUID RESUSCITATION WITH SODIUM,POTASSIUM,MAGNESIUM,CALCIUM,AND GLUCOSE FLUID ON SUBLINGUAL MICROCIRCULATION IN RABBITS WITH SEPTIC SHOCK

作　　者：张鹏[1] 孙运波[1] 山峰[1] 张赛 滕金龙[1] 李连弟[1] ZHANG Peng;SUN Yunbo;SHAN Feng;ZHANG Sai;TENG Jinlong;LI Liandi(Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院重症医学科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2019年第2期216-219,224,共5页Journal of Qingdao University(Medical Sciences)

基　　金：吴阶平医学基金会资助项目(HRJJ20171017)

摘　　要：目的观察脓毒症休克兔在钠钾镁钙葡萄糖液(LJ液)复苏期间舌下微循环的变化及其临床意义。方法日本大耳白兔24只,随机分为脓毒症休克组、生理盐水复苏组、LJ复苏组及对照组,每组6只。经耳缘静脉注射脂多糖建立内毒素休克模型,对照组不注射内毒素。应用侧流暗场成像技术(SDF),观察各组在休克0、1、3、6h进行相应液体复苏后舌下微循环的总血管密度(TVD)、灌注血管密度(PVD)、灌注绒毛比例(PPV)、绒毛微血管血流指数(MFI)等指标差异。结果休克1h,生理盐水复苏组与LJ复苏组舌下微循环的TVD、PVD、MFI均优于同时间点脓毒症休克组(F=120.80～488.93,P<0.05)。休克3h,生理盐水复苏组与LJ复苏组的PPV明显优于同时间点脓毒症休克组(F=89.88,P<0.05),LJ复苏组舌下微循环TVD与PVD较生理盐水复苏组明显改善(F=181.81、488.93,P<0.05)。休克6h,LJ复苏组舌下微循环PPV与MFI较生理盐水复苏组明显改善(F=89.88、120.80,P<0.05)。结论 LJ液对脓毒症休克兔液体复苏后舌下微循环灌注的改善效果好于生理盐水。Objective To investigate the change in sublingual microcirculation during fluid resuscitation with sodium, potassium, magnesium, calcium, and glucose fluid (LJ solution) in rabbits with septic shock and its clinical significance. Methods A total of 24 Japanese white rabbits were randomly divided into septic shock group, saline resuscitation group, LJ resuscitation group, and control group, with 6 rabbits in each group. A model of endotoxin shock was established by lipopolysaccharide injection via the ear vein, and the rabbits in the control group were not injected with endotoxin. Sidestream dark-field imaging was used to observe the differences between groups in total vessel density (TVD), perfused vessel density (PVD), proportion of perfused vessels (PPV), and microvascular flow index (MFI) after fluid resuscitation at 0,1,3, and 6 h of shock. Results At 1 h of septic shock, the saline resuscitation group and the LJ resuscitation group had significantly better TVD, PVD, and MFI than the septic shock group ( F =120.80-488.93, P <0.05). At 3 h of septic shock, the saline resuscitation group and the LJ resuscitation group had a significantly better PPV than the septic shock group ( F =89.88, P <0.05), and compared with the saline resuscitation group, the LJ resuscitation group had significant improvements in TVD and PVD of sublingual microcirculation ( F =181.81 and 488.93, P <0.05). At 6 h of septic shock, compared with the saline resuscitation group, the LJ resuscitation group had significant improvements in PPV and MFI of sublingual microcirculation ( F =89.88 and 120.80, P <0.05). Conclusion LJ solution has a better effect than normal saline in improving sublingual microcirculation perfusion after fluid resuscitation in rabbits with septic shock.

关 键 词：休克 脓毒症 微循环 侧流成像暗场 液体复苏 治疗结果 

分 类 号：R972.5[医药卫生—药品]