18例非失血性休克患者输血后临床分析

目的：研究休克患者输血后出现的病情变化与再灌注综合征的关系。方法：回顾性总结分析１９９３年１月～１９９７年１月我院收治的１８例非失血性休克患者输血前后临床表现比较。结果：１８例患者均发生病情突然恶化，其中６６７％（１２／１８）发生在输血４～２４ｈ内，１３例死亡，５例恢复正常。结论：休克患者输血后病情恶化可能与缺血 再灌注损伤有关。提出对非失血性休克患者输血应持慎重态度，若必须输血，则应在休克早期进行，同时注意预防再灌注损伤。

A Clinical Analysis of 18 Cases of Non-hemorrhagic Shock after Blood Transfusion

Objectives:To evaluate whether bacterial translocation occurs during portal triad clamping (PTC) and attempt to explore it's correlative mechanism Methods:The mean counts per minute (cpm) of radio labeled E coli ATCC 2 529 in groups with PTC were determined,plasma endotoxin levels in portal and systemic blood,the blood flow of the intestinal loops and the ilicocecal mucosal surface and the mean portal PO 2 were detected,histologic features of the gut were analyzed during PTC Results:BT into portal blood from the guts could be detected as early as 15 min following PTC in rats and increased with the increasing length of PTC,plasma endotoxin levels in portal and systemic blood were significantly increased,the blood flow of guts were profoundly declined in all the experimental groups during PTC Conclusions:Bacterial translocated into portal blood and splanchnic organs form the guts could be detected as early as 15 min following PTC We conclude that translocation of the intestinal bacterial flora is due to reduction in blood flow of the guts and in portal PO 2 and acute gut barrier dysfunction during PTC