高渗氯化钠高氧液对失血性休克家兔血乳酸和动脉血气的影响

目的:观察高渗氯化钠高氧液对失血性休克家兔动脉血气和血乳酸值的影响，评价其对失血性休克的早期救治效果。方法:制备高渗氯化钠溶液(HS)、生理盐水高氧液（NSO）和高渗氯化钠高氧液(HSO)。30只雄性家兔制备失血性休克模型［于10min内使平均动脉压（MAP）降至40mmHg（1mmHg＝0.133kPa），维持60min］，随机分为NSO，HS，HSO组3个治疗组。分别按6mL/kg剂量5min内静脉输入NSO,HS和HSO。记录休克前后及给药后心率（HR）、呼吸（RR）、MAP及尿滴（UD），测定休克前、休克60min，给药后30，60，120min时血乳酸（BL）和动脉血气值。最后观察尸肺，测定肺系数。结果:HS和HSO组均显著地改善MAP，HR和UD，降低BL，改善代谢性酸中毒,肺系数明显低于NSO组。HSO与NSO及HS比较，能更显著地降低血BL，提高动脉血氧饱和度（SaO2）和动脉血氧分压（PaO2）。结论:HSO较HS和NSO能更显著地降低血BL,提高SaO2和PaO2，对失血性休克的早期救治具有较高的使用价值。

Effects of hyperoxic-hyperosmotic sodium chloride solution on blood lactate and arterial blood gas in rabbits with hemorrhagic shock

Abstract:Objective:To investigate the effects of hyperoxic-hyperosmotic sodium chloride solution(HHSCS) on arterial blood gas and blood lactate in rabbits with hemorrhagic shock, and evaluate the HHSCS effects on hemorrhagic shock resuscitation. Methods:Hemorrhagic shock models were induced in 30 male rabbits. The median arterial pressure(MAP) was declined to 40mmHg within 10 minutes, then maintained for 60 minutes. The animals were then randomly divided into 3 groups:normal saline hyperoxic solution (NSO)group, hyperosmotic sodium chloride solution (HS)group and HHSCS group. Sixty minutes later, NSO，HS or HHSCS 6ml/kg was infused intravenously in 5 minutes. Heart rate(HR) 、respiratory rate(RR)、 MAP and urine drops(UD) before shock and after fluid infusion were recorded; blood lactate(BL) and blood gas were measured before shock，60min after shock，and 30min，60min，120min postinfusion. Finally, the rabbits were killed by bleeding, the lungs were observed in autopsy, and the lung coefficient was measured. Results:HS and HHSCS more effectively raised MAP,enhanced heart function,and increased UD than NSO. HHSCS group significantly reduced BL. At 60,120min after infusion, SaO2 in HHSCS group was significantly higher than that in HS group and NSO group(P<0.05),and PaO2 was significantly higher than HS group and NSO group at 30 min after infusion(P<0.05). The lung coefficient in HS group、HHSCS group was less than that in NSO group(P<0.01). Conclusions:HHSCS can more efficiently decrease BL and increase blood SaO2 and PaO2 than NSO and HS did, and is more effective for hemorrhagic shock resuscitation.