不同液体对脓毒性休克早期大鼠复苏效果的观察

目的：通过观察不同液体用于脓毒性休克早期大鼠复苏,比较其复苏成功率及所用时间、重要脏器心脏和肺脏的病理改变,了解各复苏液的效果.方法：72只成年雄性SD大鼠随机分为9组.（1）正常对照组（n=8）;（2）脓毒性休克早期组（n=8）,通过颈外静脉注射内毒素（10 mg· kg1）建造脓毒性休克早期大鼠模型,不予任何干预.（3）干预组（n=56）,又分为7个亚组,每组n=8：生理盐水组、低分子右旋糖酐组、人血清蛋白组、生理盐水＋低分子右旋糖酐组、生理盐水＋人血清蛋白组、生理盐水＋低分子右旋糖酐＋人血清蛋白组（混合组）、低分子右旋糖酐＋人血清蛋白组（胶体混合组）.造模成功后分别给予上述不同的液体复苏.结果：复苏成功率及复苏时间比较：生理盐水组和混合组复苏成功率最高,分别为87.50％和83.33％;人血清蛋白组和低分子右旋糖酐组效果最差,其复苏成功率分别为16.67％和25.00％,与生理盐水组比较差异有统计学意义（P＜0.05）;生理盐水组需要的平均时间最短[（18.50±8.85） min],而低分子右旋糖酐组、人血清蛋白组及低分子右旋糖酐＋人血清蛋白组复苏所需的时间相对较长,与生理盐水组比较差异均有统计学意义（P＜0.05）.光镜及电镜下心脏、肺脏组织病理改变：脓毒性休克早期组病理改变最明显;各液体复苏干预组中,生理盐水组效果最好,其次是生理盐水＋人血清蛋白组、生理盐水＋低分子右旋糖酐组,而单纯胶体（人血清蛋白、低分子右旋糖酐）及胶体混合组效果最差.结论：脓毒性休克早期液体复苏首选生理盐水,如生理盐水复苏效果不理想,可考虑联合人血清蛋白等胶体进行液体复苏.

EFFECT OF DIFFERENT RESUSCITATION FLUIDS ON THE EARLY STAGE OF SEPTIC SHOCK IN RATS

Objective：To observe the effect of different resuscitation fluids on the early stage of septic shock in rats.Methods：Seventy two adult male SD rats were randomly divided into （1） normal control group （n=8） ; （2） septic shock group （n=8）,external jugular vein injection of endotoxin （10 mg/kg） ; and （3）Seven intervention groups （saline,dextran,albumin,saline＋low molecular spin glycosidic,saline＋albumin,saline＋low molecular spin glycosidic＋albumin,and low molecular spin glycosidic＋albumin groups;n =8 for each group）.External carotid intravenous endotoxin model was given different liquids until recovery was established.Results：The recovery success rate was the highest in saline （87.5%） and in mixed （83.33%） groups,and the worst in albumin （16.67%） and dextran （25%） groups （P〈0.05 compared with the saline group） in the all intervention groups.In all intervention groups,the average time of successful resuscitation required by the saline group was the shortest [（18.50±8.85） min],recovery of low molecular weight dextran,albumin,and dextran＋albumin groups required a relatively longer time,compared with the saline group （P 〈0.05）.Light and electron microscope showed that the pathological changes of lungs and heart in septic shock group were most obvious.In all of the different liquid recovery groups after intervention,the normal saline group was the best,followed normal saline ＋ albumin group,normal saline ＋ dextran 40 sodium chloride group,and pure gel （albumin,dextran 40 sodium chloride）,and the colloid mixed group was the worst.Conclusion：Fluid resuscitation in the early stage of septic shock preferred normal saline,if normal saline didn＇t achieve an ideal effect,we could consider mixing albumin and other colloid for fluid resuscitation.