不同输液方式对非控制性失血性休克大鼠复苏效果的影响  

Effect of Different Fluid Infusion Methods on Resuscitation in Rats with Uncontrolled Hemorrhagic Shock

作　　者：屈伸[1] 陈易[1] 汤翠翠[2] 

机构地区：[1]宁夏医科大学总医院麻醉科,银川750004 [2]宁夏医科大学总医院肿瘤医院,银川750004

出　　处：《宁夏医科大学学报》2016年第10期-,共4页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金(NZ14280)

摘　　要：目的 观察不同输液方式对失血性休克大鼠复苏效果的影响.方法 健康雄性SD大鼠48只随机分为4组(n=12),麻醉后A组(对照组)给予股动、静脉置管,不行放血、断尾及补液.B、C、D三组大鼠给予动、静脉置管后行放血和回输使平均动脉压(MAP)=40mmHg,后切除3/4的鼠尾造成活动性出血,维持MAP=35～40mmHg 60min,作为失血性休克模型.液体复苏期60min,用乳酸林格氏液(LR)和6％羟乙基淀粉(6％HES130/0.4)做为复苏液体静脉输注:B组(限制输液组)通过输注复苏液体维持MAP在60mmHg左右;C组(开放输液组)通过输注复苏液体维持MAP在100mmHg以上;D组(无输液组)在断尾处止血前不予任何液体.3组休克大鼠在随后的60min急救期接受结扎止血和适量的输血和液体输注.液体复苏结束后取动脉血测定血色素(Hb)、红细胞压积(Hct)和碱剩余(BE).结果 4组大鼠体重、体温、MAP、心率(HR)等基础值比较差异均无统计学意义(P均＞0.05);各组大鼠死亡率比较差异无统计学意义(P＞0.05);C组输液量高于B、D组;各休克组动物复苏后血Hb、Hct水平和BE低于对照组,C组BE值、Hct和Hb均低于B组(P均＜0.01),D组Hct和Hb低于B组(P均＜0.01),D组BE值高于B组(P＜0.01).结论 大鼠非控制性失血性休克采用限制输液方式(维持MAP=60mmHg)有利于减少活动性出血、减轻血中BE值的降低,从而改善复苏效果.Objective To compare the effect of different fluid infusionmethods on resuscitation in hemorrhagic shock rats and to explore the mechanisms.Methods 48 Sprague-Dawley rats were allocated to four group randomly(n=12).The animals were anesthetized by an introperitoneal injection of sodium pentobarbital and orally intubated.Right side femoral artery and vein were cannulated.Rats in group A(sham group) were subjected to the surgical procedure without causing a hemorrhage and any addition of IV fluid.Rats in all group except group A were withdrawn blood through the femoral artery to a MAP of 40 mm Hg.Uncontrolled hemorrhagic shock was achieved by 75 percent tail amputation.Rats was induced by tail amputation and withdrawing or returning blood to maintain MAP 35~40mm Hg during hemorrhage for 60 mins.Rats in group B received fluid resuscitation to a target MAP of 60 mm Hg.Rats in group C received fluid resuscitation to a target MAP of 100 mm Hg While rats of group D received nothing.At 120 minutes after tail amputation,the cut end of the tail was tied to stop the bleeding.The rats were given fluids or blood to maintain MAP more than 100 mm Hg and hematocrit(Hct)higher than 30%.After 260 mins of surgery,All rats were extubated and the femoral artery and vein catheters was removed.All of the rats were returned to their cage.Results The Hb,HCT and BE in group B,C,D decreased significantly compared with that of sham group(P<0.01).The BE in group B increased significantly than that of group C.The volume of blood lost and fluid given decreased significantly and remained a higher Hct in group B compared with that of group C(P<0.01).Conclusion Limited fluid resuscitation can help reduce active bleeding and reduce BE decreasing tendency,thus improve the effect of recovery in rats undergoing uncontrolled hemorrhagic shock.

关 键 词：非控制性失血性休克 液体复苏 碱剩余 

分 类 号：R459.7[医药卫生—急诊医学]