高氧液对重度失血性休克家兔血压和血气的影响  

Effects of hyperoxic solutions on blood pressure and blood gas during severe hemorrhagic shock in rabbits

作　　者：胡渤[1] 熊利泽[1] 陈绍洋[1] 雷毅[1] 王强[1] 张惠[2] 

机构地区：[1]第四军医大学西京医院麻醉科,陕西西安710033 [2]第四军医大学口腔医学院麻醉科,陕西西安710033

出　　处：《第四军医大学学报》2004年第9期776-779,共4页Journal of the Fourth Military Medical University

基　　金：军队"十五"课题 (0 1MA2 0 3)

摘　　要：目的 :观察高氧液 (HO)对重度失血性休克家兔平均动脉压 (MAP)、血气和存活率的影响 ,评价其在失血性休克早期复苏中的价值 .方法 :以临床常用晶体、胶体液为基液制备HO ,4 8只家兔随机分为两组 :高氧液组 (HO组 )和对照组 ,每组 2 4只 ,两组又随机各分为 4个亚组 :6 0g/L羟乙基淀粉组(HES组 )、聚明胶肽组 (Pol组 )、琥珀酰明胶组 (Gel组 )和平衡盐组 (RS组 ) ,每组 6只 .制备家兔失血性休克模型 ,经股动脉在 5min内放血 ,放血量占全身血量的 4 5 %～ 5 0 % ,使MAP迅速降至 2 .6 7kPa(2 0mmHg) .于休克前、休克 30min、复苏结束、复苏后 30min和 6 0min记录MAP ,并于以上各时间点自右侧股动脉采血进行血气分析 ,记录动物 2 4 ,4 8,72和 96h存活率 .结果 :与对照组相比 ,HO组提高PaO2 能力与对照组无明显差异 ,但HO组可以提高动物生存率 ,明显纠正酸中毒 ,有效提高并稳定MAP .结论 :在重度失血性休克的早期救治中 ,HO具有良好的复苏能力 。AIM: To investigate the effects of hyperoxic solutions on blood pressure, blood gas and survival rate during severe hemorrhagic shock in rabbits. METHODS: Forty eight rabbits weighing (2.2-2.8) kg were randomly divided into two groups ( n =24 each): hyperoxic solutions group (HO group) and control group. Each group was randomly allocated to four experimental groups: hydroxyethylstarch (HES, n =6), polygenine (Pol, n =6), gelofusine (Gel, n =6) and Ringer’s solution (RS, n =6). Anesthesia was induced with 30 mg/mL pentobarbital sodium 30 mg/kg. The right femoral artery was cannulated for MAP monitoring and blood collection, 45%-50% of the whole blood volume was exsanguinated in 5 min and MAP was rapidly reduced to 2.67 kPa. Thirty min later, the animals were resuscitated with various solutions based on group assignment within 10 min. Blood gas was analyzed before and 30 min after shock, at the end of resuscitation and 30 min and 60 min after resuscitation. The animals were carefully observed for 3 days and the survival rate at 24 h, 48 h, 72 h and 96 h was analyzed. RESULTS: There was no significant difference in PaO 2 between HO group and control group after resuscitation. But, the survival rate of HO group was significantly higher than that of control group. In HO group, acidosis was reduced and increased and MAP was sustained MAP significantly. CONCLUSION: HO is more effective in the early therapeutic stage of hemorrhagic shock.

关 键 词：休克 失血性 液体治疗 高压氧 血气分析 

分 类 号：R363[医药卫生—病理学]