高渗盐水和甘露醇在动脉瘤性蛛网膜下腔出血患者降低颅内压中的应用

目的比较3%高渗盐水和20%甘露醇治疗重症动脉瘤性蛛网膜下腔出血所致颅内压增高的疗效.方法25例动脉瘤性蛛网膜下腔出血患者出现颅内压增高事件时, 随机交替接受等渗透剂量的160 mL 3%高渗盐水与150 mL 20%甘露醇进行降低颅内压治疗, 连续监测患者颅内压、平均动脉压、脑灌注压及中心静脉压.记录有效降低颅内压持续时间、颅内压最大降幅及其时间, 用药前及用药后1 h、3 h血钠水平及血浆渗透压.结果3%高渗盐水和20%甘露醇均可降低颅内压(均 P < 0.01), 两者的降低颅内压作用持续时间及颅内压降幅差异均无统计学意义(均 P >0.05).患者脑灌注压较用药前均上升(均 P < 0.01), 平均动脉压先上升后下降, 但差异无统计学意义( P >0.05).患者中心静脉压稍有波动, 但差异均无统计学意义(均 P >0.05).20%甘露醇治疗后患者血钠下降, 3%高渗盐水治疗后患者血钠值上升, 变化均有统计学意义(均 P < 0.05).20%甘露醇及3%高渗盐水治疗后患者血浆渗透压均先上升后下降, 变化均有统计学意义(均 P < 0.01). 结论3%高渗盐水可作为治疗动脉瘤性蛛网膜下腔出血所致颅内压增高患者的一线治疗药物.     

Recipient hypertonic saline infusion prevents cardiac allograft dysfunction

Objective

Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.

乳酸林格氏液、高渗盐水和全血对失血性休克犬血液动力学的影响

以失血性休克犬为研究对象，比较乳酸林格氏液（LR）、高渗盐水（HS）和全血（WB）对其血液动力学的影响。经右颈外静脉插入Swan-Ganz飘浮导管，分别在全身氧供（DO2）恢复至休克前水平时，以及液体复苏后5、10、15、30、60和120min时测量动物的各项血液动力学指标。结果显示，HS仅需要11．83ml/kg的液体量，在4．97min时即可使休克犬的DO2恢复至休克前的水平，而LR组和WB组则分别需要52．08ml/kg和23．33ml/kg的液体量，在20．83min和9．33min时才能使休克犬的DO2恢复至休克前的水平。3组动物在DO2恢复至休克前水平时其血液动力学指标均能恢复至休克前的水平。提示高渗盐水比乳酸林格氏液和全血更适合失血性休克患者的早期紧急液体复苏治疗。     

硬膜外高渗氯化钠溶液术后镇痛的临床双盲研究

为观察高渗盐水硬膜外注射术后镇痛效果,用双盲法对60例病人进行了研究。生理盐水对照级术后镇痛优良率为3.33％,镇痛有效率为10％,均需用镇痛药;高渗盐水组术后镇痛优良率为86.67％,有效率为96.67％,很少使用镇痛药。两组差别显著(P<0.05,P<0.01)。对其他感觉和运动功能无明显影响。高渗盐水组与吗啡组比较镇痛效果相同(P>0.05),副作用少(P<0.01)。说明硬膜外高渗氯化钠溶液是一种安全有效的镇痛方法,有较高推广应用价值。     

高渗盐液和抗休克裤合并应用对大鼠早期休克的影响

采用高渗盐液，抗休克裤及两者联用纠正大鼠早期失血性休克。结果显示，单独使用ＡＳＴ，仅见动脉血压短时间回升，而单用ＨＴＳ，血压则明显回升。若先用ＡＳＴ，再注入ＨＴＳ，也能取得明显效果。失血休克大鼠血浆纤维连接蛋白水平显著降低，各组之间均无差异血浆脂质过氧化物－丙二醛的含量明显增加，且在ＨＴＳ组，ＨＴＳ＋ＡＳＴ组与ＮＳ对照组之间有显著差异。     

Plasma Separator for Encapsulating Fluorescent Probe in Erythrocytes

Using a plasma separator, it is possible to wash large volumes of whole blood free of plasma proteins in short periods. The novelty, however, is that the same apparatus can be used to reversibly hemolyze and reseal the red blood cells (RBCs) using hypotonic and hypertonic dialysates, respectively. This technique was assessed using the fluorescent exogenous agent uranin (fluorescein sodium). Results indicate that the encapsulation of the RBCs can be completed in under 2 h. The encapsulation efficiency of the RBCs was approximately 80% with a RBC recovery rate of 75%.     

Blood flow variation and energy metabolism in the gastric mucosa following 7．5％ hypertonic saline resuscitation

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豚鼠离体心脏心电场分布的研究

目的确定豚鼠心电场的分布本质。方法将26只离体豚鼠心脏浸入蒸馏水和生理盐水中,将参比点置于远离心电场源的零电位,记录3个平面左、右心室侧和与之垂直的前后侧共4个方向上不同距离的心电图。结果每一平面4个方向上共16个点在两种溶液中都记录到以正波为主的心电图。结论排除导联参比点对体表标测的影响,心电场一致向外的分布方式表明心电场不是偶极场,可能是一个拟球面分布的单源场。     

CROMAKALIM SUPPRESSES HYPERTONIC SALINE-INDUCED RENAL VASOCONSTRICTION IN ANAESTHETIZED DOGS

1. Intrarenal arterial infusion of hypertonic saline (HS) transiently increased and then gradually reduced renal blood flow (RBF) in anaesthetized dogs. Glomerular filtration rate (GFR) but not filtration fraction decreased at the end of the infusion. 2. In the presence of a potassium channel opener cromakalim (0.3 μg/kg per min), HS infusion failed to reduce RBF; the initial increase in RBF was maintained throughout the infusion. Since cromakalim also prevented the decrease in GFR, HS infusion lowered filtration fraction. 3. The results suggest that cromakalim inhibits both pre-and postglomerular vasoconstriction induced by HS infusion.