不同的复苏压力对非控制失血性休克大鼠肺功能的影响

目的比较不同的液体复苏压力对非控制失血性休克大鼠肺功能的影响。方法制备大鼠创伤非控制失血性休克模型。将60只远交群大鼠随机分为6组各10只：NC组为对照组；NF组为休克不复苏组；NS40、NS60（限制性液体复苏组）、NS80、NS100（大量液体复苏组）。各液体复苏组在大鼠的平均动脉压（MAP）降至35-40mmHg（1mm Hg=0．133kPa）时分别给予生理盐水输注，使血压维持在各相应水平。输液1h后，各液体复苏组均给予手术止血、回输血液及给予足量的液体输注，保持大鼠的MAP≥90mmHg。结果在出血未控制的情况下，限制性液体复苏组的出血量明显低于大量液体复苏组，肺组织病理学损害、酸中毒程度较大量液体复苏组明显减轻。NS60组有9只大鼠存活超过72h，NS40组3只存活超过72h，而NF组与NS80、NS100组无一只存活超过72h。结论创伤非控制失血性休克及不同的液体复苏压力均可造成不同程度的肺损伤，限制性液体复苏对肺功能具有保护作用。

Influence of different resuscitation pressure on lung function of rats with uncontrolled hemorrhagic shock

Objective To compare the effects of different resuscitation pressure on lung function of rats with uncontrolled hemorrhagic shock. Methods Uncontrolled hemorrhagic shock model of rats was built. Sixty Sprague-Dawley rats were randomly sent into six groups： NC group （the control group）, NF group （shock but non-resuscitation）, NS40, NS60 group （limited fluid resuscitation）, NS80, NS100 group （large-volume fluid resuscitation）. When the mean arterial pressure （MAP） reached between 35 mm Hg to 40 mm Hg （1 mm Hg--0.133kPa） resuscitation was begun, normal saline infusion was used to maintain the following desired endpoints. After the fluid resuscitation for one hour, rats of each fluid resuscitation group were given haemostasis and all-out fluid resuscitation, including blood infusion, to maintain the rats＇ MAP at 90 mm Hg. Results Findings showed that the blood loss in limited fluid resuscitation groups was significantly lower than that in large-volume fluid resuscitation groups at the situation of uncontrolled hemorrhagic shock, damage to lung tissue pathology and acidosis were significantly lower than those in large-volume fluid resuscitation groups. Nine rats in NS60 group survived 72 hours. Three rats in NS40 group survived 72 hours. No rat in NF group as well as in both NS80 and NS100 groups survived 72 hours. Conclusions Uncontrolled hem-orrhagic shock in trauma and different pressure of fluid resuscitation can cause tung injury to varying de-grees. Limited fluid resuscitation provide significant protective effects against such injuries.