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纸质出版:2008
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李涛,刘良明,刁有芳,廖自福,范小青,陈凤.几种不同液体复苏失血性休克大鼠的适宜量研究[J].陆军军医大学学报(原第三军医大学学报),2008,30(03):199-202.
LI Tao,LIU Liang-ming,DIAO You-fang,LIAO Zi-fu,FAN Xiao-qing,CHEN Feng.On proper volume of different fluids for hemorrhagic shock resuscitation in rats[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(03):199-202.
李涛,刘良明,刁有芳,廖自福,范小青,陈凤.几种不同液体复苏失血性休克大鼠的适宜量研究[J].陆军军医大学学报(原第三军医大学学报),2008,30(03):199-202. DOI:
LI Tao,LIU Liang-ming,DIAO You-fang,LIAO Zi-fu,FAN Xiao-qing,CHEN Feng.On proper volume of different fluids for hemorrhagic shock resuscitation in rats[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(03):199-202. DOI:
目的 对几种不同液体复苏失血性休克大鼠适宜量进行探讨。 方法 SD大鼠分别做35%、45%放血失血性休克模型,以不同量的乳酸林格液(LR)、羟乙基淀粉(HES)、高渗氯化钠右旋糖酐(HSD)和LR+HES进行复苏,观察其对失血性休克大鼠平均动脉血压(mean arterial blood pressure
MAP)、左心室收缩压(left intraventricular systolic pressure
LVSP)、左心室压力上升或下降的最大速率(the maximal change rate of left intraventricular pressure
±dp/dt
max
)的影响,同时观察血气指标变化和存活率的变化。 结果 在35%失血性休克(中度休克)时,不同剂量的LR、HSD输注对休克大鼠血流动力学的影响无显著差异(P0.05);30 ml/kg HES输液后血流动力学指标明显优于20 ml/kg HES(P0.05);1倍失血量LR+HES输注优于2倍和3倍失血量的LR+HES(P0.05)。在45%失血性休克(重度休克)时,3倍失血量LR输液后血流动力学指标明显比1倍和2倍失血量的LR效果好(P0.05);6 ml/kg的HSD输注后血流动力学效果比4、8 ml/kg 的HSD效果好(P0.05)。同样,30 ml/kg HES和2倍失血量的LR+HES输液后改善血流动力学指标,血气指标和存活时间效果优于其他剂量组的HES和LR+HES(P0.05),除HSD各剂量组明显降低血pH值外,其他各液体对血气指标的影响均不大。 结论 LR除复苏重度休克以3倍失血量输注效果好外,其余液体以HES 30 ml/kg,HSD 6 ml/kg以及2倍失血量的LR+HES复苏失血性休克效果较好,是较理想的失血性休克复苏容量。
Objective To study the proper volume of different fluids to resuscitate hemorrhagic shock in rats. Methods SD rats were hemorrhaged to 35% or 45% total blood volume. Then lactated ringer’s (LR) of 1×
2×
3× shed blood volume
20 or 30 ml/kg hydroxyethyl starch (HES)
7.5%NaCl/
6%Dextran40 (HSD) at dose of 4
6
8 ml/kg
LR+HES of 1×
2×
3× shed blood volume were transfused to resuscitate the rats
respectively. Mean arterial blood pressure (MAP)
left intraventricular systolic pressure (LVSP)
the maximal change rate of left intraventricular pressure (±dp/dt
max
) were observed before and after hemorrhagic shock
1 and 2 hours after transfusion. Blood gas was detected 1 h after transfusion and at the end of transfusion and 12-hour survival rate of the animals was also observed. Results For the rats with 35% total blood loss
the effects of LR and HSD on hemodynamic parameters were not significantly different. HES at dose of 30 ml/kg and HES+LR of 2× shed blood volume improved hemodynamic parameters and the survival rate as compared with HES at 20 ml/kg and other LR+HES groups. For the rats with 45% total blood loss
LR of 3× shed blood volume and HSD at 6 ml/kg improved hemodynamics better than LR of 1×
2× shed blood volume and HSD at 4 and 8 ml/kg. Similarly
HES at 30 ml/kg and LR+HES of 2× shed blood volume improved the hemodynamic parameters and survival rate better than HES at 20 ml/kg and HES+LR of 1×
2×shed blood volume. For blood gas
all fluids had no obvious effect
except that HSD significantly decreased the blood pH value. Conclusion Besides LR of 3× shed blood volume is effective in resuscitating the rats of 45% total blood loss
the transfusion of HES at 30 ml/kg
HSD at 6 ml/kg or LR+HES of 2× shed blood volume achieves better resuscitation effect in the rats of 35% or 45% total blood loss.
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