复苏液对失血性休克大鼠血流动力学的影响

目的 探讨不同复苏液对失血性休克大鼠血流动力学的影响及其可能的机制.方法 SD大鼠50只随机分为5组:对照组、假手术组、休克组、复苏1组(输林格液)和复苏2组(输林格液 万汶液),每组10只,建立失血性休克大鼠模型.在制模成功后复苏1组给予林格液,复苏2组给予林格液 万汶(6%中分子羟乙基淀粉130/0.4).观察并记录各组大鼠的血流动力学变化:收缩压(SBP)、舒张压(19BP)、平均动脉压(MAP)、心率(HR)和呼吸频率(RR).结果 血流动力学变化:复苏1组、复苏2组两组大鼠在制成失血性休克模型后,休克即时的SBP、DBP和MAP均较基础值明显降低,HR较基础值明显加快(P＜0.05).复苏2组复苏后各时间点SBP、DBP和MAP均恢复到接近基础值水平(P＞0.05);但复苏1组复苏30min的DBP,复苏60rain、90min和120rain的SBP、DBP和MAP均明显低于基础值,复苏后90min和120rain的HR较基础值和复苏2组明显加快(P＜0.05).复苏1组的自主呼吸频率在复苏30min和复苏60min时明显增快,与基础值相比差异有统计学差异(P＜0.05).复苏1组复苏后各时段的DBP、MAP、SBP明显降低,与复苏2组相比,差异有统计学意义(P＜0.05).复苏1组复苏30min及复苏60min的呼吸频率明显加快,与复苏2组相比,差异有统计学意义(P＜0.05).结论 羟乙基淀粉具有较好的扩容效果,能显著改善血流动力学,增加有效循环血容量,改善毛细血管渗漏综合征,改善因有效循环血容量不足引起的休克等症状.

Effects of Resuscitation Fluids on Changes of Hemodynamic Values in Rats with Hemorrhagic Shock

Objective The study was aimed to investigate the effects of two resuscitation fluids on changes of hemodynamic values and to clarify its possible mechanism in hemorrhagic shock rat.Methods 50 Sprague-Dawley(SD)rats were randomly divided into 5 groups:control,sham,shock,resuscitation 1(infusion with Ringer's solution)and resuscitation 2(infusion with 6% VOLUVEN plus Ringer's solution)with ten rats per group.The rats in resuscitation 1 and resuscitation 2 groups were subjected to hemorrhagic shock and resuscitation were performed with Ringer's solution and 6% Voluven.Changes of hemodynamic values of various groups rats were observed and recorded.The hemodynamic values inclouded systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial blood pressure(MAP),heart rate(HR)and respiratory rate(RR).After 2 hours of shock,the various group rats were bloodletted out so as to test and were executed.Results On the time of shock forwith,SBP,DBP and MAP of resuscitation 1 group and resuscitation 2 group were lower and the HR were faster as compared with foundation values(P<0.05).SBP,DBP,MAP and HR after resuscitation of resuscitation 2 group were approached to foundation value(P>0.05),but DBP at resuscitation 30 minutes of resuscitation 1,SBP,DBP and MAP after resuscitation for 60,90 and 120 minutes of resuscitation 1 group were lower as compared with foundation values,and the HR were faster than foundation values after resuscitation for 90 and 120 minutes(P<0.05).RR after 30 and 60 minutes resuscitation of resuscitation 1 group were more rapid as compared with foundation values(P<0.05).SBP,DBP and MAP were lower on the any time of resuscitation 1 group as compared with resuscitation 2 group(P<0.05).RR were more rapid after resuscitation for 30 and 60 minutes of resuscitation 1 group as compared with resuscitation 2 group values(P<0.05).Conclusions 6% Hydroxyethyl Starch(VOLUVEN)could expand circulating blood volume and improve hemodynamics obviously and increase effective circulating bolld volume and improve vascular leak syndrome and correct the shock symptom of effective hypovolemia.