首页 | 本学科首页   官方微博 | 高级检索  
     

液体复苏对初进高海拔地区重度失血性休克犬血流动力学的影响
引用本文:王英峰,耿智隆,刘东,李涛,汪惠文,刘斌. 液体复苏对初进高海拔地区重度失血性休克犬血流动力学的影响[J]. 中华急诊医学杂志, 2009, 18(1). DOI: 10.3760/cma.j.issn.1671-0282.2009.01.011
作者姓名:王英峰  耿智隆  刘东  李涛  汪惠文  刘斌
作者单位:1. 兰州军区兰州总医院麻醉科,兰州,730050
2. 兰州军区兰州总医院,病理科,兰州,730050
基金项目:军队面上课题,甘肃省自然科学基金 
摘    要:目的 探讨液体复苏对初进高海拔地区重度失血性休克犬血流动力学的影响.方法 13只成年杂种犬由海拔1510 m地区用l d时间运至3780 m的高海拔地区,随机分为三组(n=13).每只犬麻醉后经颈静脉放置漂浮导管,开放股动、静脉通道,经股动脉放血,使MAP维持在(35±5)mmHg,建立重度失血性休克模型.对照组(n=3):休克模型复制后1 h不进行液体复苏;LR组(n=5):休克1 h后输入1.5倍失血量的LR;6%HES组:休克1 h后输入等失血量的6%HES(n=5):三组犬休克模型复制后每小时以5 mL/ks的速度输注LR作为维持量,观察血流动力学变化.结果 对照组犬在休克模型复制后2 h内全部死亡,较休克1h差异具有统计学意义(P<0.05).其他两组液体复苏后2 h时:LR组MAP,CO,PAWP,CVP,LVSWI,RVSWI较休克1 h显著升高(P<0.05),而HR,SVR,PvR较休克l h显著降低(P<0.05);6%HES组CO,PAP,PAWP,CVP.SVR,PVR较休克1 h显著升高(P<0.05),而MAP,HR,CI,LVSWI,RVSWI较休克1 h差异无统计学意义(P>0.05).,结论 初进高海拔地区的重度失血性休克犬,如果不进行有效的液体复苏,死亡均为(3/3);输入1.5倍失血最的TJR是安全有效的;输入等失血量的6%HKS容易导敛心力衰竭.

关 键 词:液体复苏  高海拔地区  血流动力学  失血性休克

Effects of fluid resuscitation on hemodynamics of the dogs with hemorrhagic shock at initial stage of entering the area of high altitude
WANG Ying-feng,GANG Zhi-long,IdU Dong,Li Tao,WANG Hui-wen,LIU Bin. Effects of fluid resuscitation on hemodynamics of the dogs with hemorrhagic shock at initial stage of entering the area of high altitude[J]. Chinese Journal of Emergency Medicine, 2009, 18(1). DOI: 10.3760/cma.j.issn.1671-0282.2009.01.011
Authors:WANG Ying-feng  GANG Zhi-long  IdU Dong  Li Tao  WANG Hui-wen  LIU Bin
Abstract:Objective To investigate the effect of fluid resuscitation on hemodynamics in dogs with hemorrhagic shock at the initial stage of getting high altitude. Method he models of severe hemohagic shock were established in 13 mongrel dogs after they were brought to the high altitude a/ea and were mndondvvided inIo 3 group: LR group(n=3),6% HES group(n=5)and control group(n=5).The dogs in LR group wefe intravenously infused with lactated Ringers solution in 1.5 limes exsanguinated volume;those in 6% HES group were given hydroxyethyl starch in equal volume of exsanquination. A drop of solution waft noven to dogs in con,trol group.One hour after restritation,lactated Ringers solution waft infused at 5 Ilps as maintenance dose.The hemodynmnic variables were recorded.Results All animals in control group died two hour later.In LR group,the hemedynamie variables including MAP,CO,PAWP,CVP,LVSWI and RVSWI two hours after infiion were signifieantly higher than those.one hour after infusion(P<0.05),while HR,SVRd PVR were significantly lower(P<0.05).In dogs of 6% HES group,CO,PAP,PAWP,CVP,SVR and PVR two hours after infusion were significantly higher than those one hour after infusion(P<0.05),but MAP.HR.CI,LVSWI and RVSWI were not significantly different(P>0.05).Conclusions All of three doith hen rhagic shock would die(3/3)at the initial stage of being brought to high altitude alles without fluid resuscitation. Fluid resuscitation with LR solution 1.5 times the exsanquinated volume was effective and safe. The infusion of 6% hydroxyethyl starch at equal volume of exsanqination may easily cause heart failure or pulmonary edema.
Keywords:Fluid resuscitation  High altitude  Hemedynamics  Hemorhagic shock
本文献已被 万方数据 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号