缩合葡萄糖对犬心肺复苏后红细胞流变学影响的实验研究

目的研究缩合葡萄糖对犬心肺复苏后红细胞流变学的影响.方法健康杂种犬16只,体质量11～20.5kg,年龄1～2岁;分段随机法分为2组:对照组(复苏后仅输注乳酸林格液,n=8)、实验组(复苏后先快速输注缩合葡萄糖氯化钠溶液,而后以乳酸林格液维持,n=8).心跳骤停(cardiac arrest,CA)前5 min、CA中第5 min、CA后30、60、80、120 min于股静脉采集血液标本测定红细胞聚集指数(RAI)、红细胞变形指数(RDI)、红细胞刚性指数(RRI)、全血高切粘度(HBV)、全血低切粘度(LBV)、卡松粘度(CV)、卡松屈服应力(CYS).结果对照组RAI、RDI、RRI、LBV、CYS复苏后均有不同程度变化(P＜0.05),HBV、CV在复苏前后无统计学差异(P＞0.05);实验组各项指标在复苏前后均无统计学差异(P＞0.05).两组各项指标对应时相比较:RAI:CPR后90、120 min差异有显著性(P＜0.05);RDI:CPR后60、90、120 min差异有显著性(P＜0.05);RRI:CPR后30、60、90、120 min差异有非常显著性(P＜0.01);LBV,CYS:CPR后90min差异有显著性(P＜0.05),CPR后120 min差异有非常显著性(P＜0.01).结论非失血性心跳骤停的心肺复苏后,输注缩合葡萄糖溶液,有利于红细胞流变学的恢复.

Effects of polyglucose solution on erythrocyte rheological changes after cardiopulmonary resuscitation in experimental dogs

Objective To investigate the effects of polyglucose solution on red blood cell rheological parameters after cardiopulmonary resuscitation in experimental dogs Methods Sixteen healthy mongrel dogs, weighting 11-20 kg, 1-2 years old, were divided randomly into 2 groups: control group (infusion of only Ringer's solution after cardiopulmonary resuscitation), trial group (quick infusion of polyglucose solution after cardiopulmonary resuscitation) Endotracheal intubation and mechanical ventilation after anesthetization with 3% barbiturate natrium (0 5-1 0 ml/kg) and vecuronium bromide (0 2 mg/kg), fentanyl and vecuronium bromide were used to maintain the anesthesia Two poles were emplaced in skin of right chest and left heart of these dogs Alternating current (50-80 V) stimulation of the dogs caused appearance of ventricular fibrillation (VF) and blood circulation arrest, and at the same time, ventilation was stopped Eight minutes later, mechanical ventilation and cardiopulmonary resuscitation (CPR) were resumed at the same time, and followed by routine support therapy after success of CPR Blood samples were collected via the femoral vein at 5 min before and after cardiac arrest (CA), at 30, 60, 90, and 120 min after CPR for the detection of RBC aggregation index (RAI), RBC deformation index (RDI), RBC rigidity index (RRI), high shear blood viscosity (HBV), low shear blood viscosity (LBV), Casson yield stress (CYS), and Casson viscosity (CV) Statistical analysis SPSS11 0 for windows was used to perform the Independent T Test and Paired samples T Test Results There were significant changes in RAI, RDI, RRI, LBV, and CYS in the control group ( P <0 05), but no significant change in HBV and CV was found before and after CPR ( P >0 05) No significant difference in parameters in the experimental group was found before and after CPR ( P >0 05) RAI at 90 and 120 min after CPR ( P >0 05), RDI at 60, 90, and 120 min after CPR ( P >0 05), RRI at 30, 60, 90, and 120 min after CPR ( P >0 01), LBV and CYS at 90 min after CPR ( P >0 05) and at 120 min after CPR ( P >0 01) in the two groups were significantly different Conclusion After CPR in non hemorrhagic CA, quick infusion of polyglucose and sodium chloride solution is beneficial to the recovery of erythrocyte rheological parameters before CPR