不同液体复苏方案对于治疗非控制性失血性休克的实验研究

目的建立非控制性失血性休克的家兔模型,探讨两种不同复苏方案对家兔的救治效果,旨在为临床院前急救提供可靠依据。方法 24只家兔改良复制成非控制性失血性休克模型,完全随机分成四组,在实验设定的时间内,采用两种复苏方案进行救治,同时测定每个时间点上各项监测指标及记录各时间点上家兔的血流动力学指标,在90 min实验结束时,处死家兔,统计出血量,补液量。结果 1）实验的30 min时,SWT、PT、LT组各组数值均未发生明显改变（P〉0.05）,模型复制成功;2）血流动力学指标变化较一致,60 min、90 min时,SWT组与LT和PT组两两比较,数值明显减小（P〈0.05）,60 min时,PT组与LT组比较,数值略大于LT组,但差异无统计学意义（P〉0.05）,90min时,LT组数值明显大于PT组（P〈0.05）;3）BL测量上,60 min时,SWT组和LT组未发生明显改变（P〉0.05）,但均比PT组数值小（P〈0.05）,90 min时,三组数据两两比较均有明显差异（P〈0.05）,PT组数值最大LT组最小;4）失血量上,PT组数值均大于SWT和LT组（P〈0.05）,LT和SWT组比较失血量改变不明显（P〉0.05）。补液量上,30~60 min、60~90 min两个时间段内时,LT组液体量明显少于PT组（P〈0.05）。结论非控制性失血性休克的早期救治中,限制性液体复苏方案补液量少,并能较好的维持各项指标的稳定,疗效明显,对于临床创伤伤员的液体复苏提供了可靠的实验依据。

Research of two methods of fluid resuscitation on therapeutic effect in rabbits of uncontrolled hemorrhagic shock

Objective Establishing the model of uncontrolled hemorrhagic shock in rabbits,we studied the therapeutic effect of two methods of fluid resuscitation on rabbits. Methods 24 rabbits were improved and duplicated the model of uncontrolled hemorrhagic shock,and distributed into 4 groups randomly,the fluid was infused via two methods of fluid resuscitation at designed time.The target and the data of hemodynamics were detected at the point of 0min,30min,60min,and 90min.Then the rabbits were reckoned the total blood loss and fluid volume at the end of experiment.Results 1） The data in SWT,PT,LT group did not change significantly（P0.05）at the point of 30min,which suggested that the model of uncontrolled hemorrhagic shock be duplicated successfully.2）Hemodynamics of rabbits changed similarly during the experiment,comparison in pairs respectively among the data in these three groups proved that the data in SWT decreased significantly（P0.05,versus LT and PT group） at the point of 60min and 90min.Tha data in PT group were little higher than that in LT group,but these changes did not have statistical significance（P0.05）at the point of 60min.At the point of 90min,the data in LT group were much higher than that in PT group obviously（P0.05）.3） BL in SWT,LT group did not change significantly（P0.05）at the point of 60min,and the data were much lower than that in PT group（P0.05）.Comparison in pairs respectively among the data of BL in these three groups showed the significant differences（P0.05） at the point of 90 min,and the maximum of the data were found in PT group,minimum in LT group.4）Compared with SWT and LT group,PT group had more total blood loss significantly（P0.05）,but total blood loss had no obviously difference between SWT and LT group（P0.05）.The fluid volume used in LT group were much fewer than that used in PT group（P0.05）at the phase of 30-60min and 60-90min.Conclusions At the first aid of uncontrolled hemorrhagic shock,limited fluid resuscitation used little fluid,maintained a better stabilization of indication and had the desirable therapeutic effect.