羟乙基淀粉130/0.4联合肾上腺素对失血性休克犬心脏功能的影响

Effect of hetastarch 130/0.4 combined with epinephrine on heart function in dog with hemorrhagic shock

为了探讨羟乙基淀粉130/0.4联合肾上腺素对失血性休克犬心脏功能的影响,试验将6只本地犬随机分为对照组和试验组,行颈总动脉插管,按照全血量的40%放血致使休克。休克后,试验组犬按体重静脉滴注羟乙基淀粉130/0.4氯化钠注射液40 mL/kg、生理盐水20 mL/kg,并肌肉注射肾上腺素0.1 mg/kg;对照组犬按体重静脉滴注生理盐水60 mL/kg。记录失血前、休克后、用药后20,50,90,120分钟和第1,2,3天时的平均动脉压(MAP)、收缩压(SP)、舒张压(DP)及心率(HR)。结果表明:失血量达到40%后试验犬进入休克状态,平均动脉压约为44.0 mmHg。用药后,两组犬收缩压均缓慢上升,试验组犬用药后50~120分钟时舒张压和平均动脉压均极显著高于对照组(P<0.01);用药后3 d内,试验组犬收缩压、舒张压、平均动脉压均逐渐上升且极显著高于对照组(P<0.01)。失血后两组犬心率明显加快,用药后逐渐降低(P<0.05或P<0.01),与对照组相比,试验组犬心率能较快接近基础值。说明羟乙基淀粉130/0.4联合肾上腺素治疗犬失血性休克能有效控制休克的继续发展。

To investigate the effect of hetastarch 130/0.4 combined with epinephrine on heart function in dog with hemorrhagic shock,in the study,6 local dogs were randomly divided into control group and experimental group.Carotid artery intubation was conducted on the neck for bloodletting at 40%of the total blood volume to cause shock.Saline was intravenously administrated 60 mL/kg in the dog of control group,hetastarch 130/0.4 sodium chloride(40 mL/kg)and saline(20 mL/kg)was intravenously administrated,and epinephrine 0.1 mL/kg was injected in the dog of experimental group after shock.Mean arterial blood pressure(MAP),systolic blood pressure(SP),and diastolic blood pressure(DP)and Heart rate(HR)were record before blood loss,after shock and after drug administration of 20,50,90,120 min,1,2,3 day.The results showed that shock came at the loss of 40%of total blood volume,MAP was approximately 44.0 mmHg at the shock state.SP increased slowly after drug administration in both groups,DP and MAP in the experimental group was extremely higher than that in the control group(P<0.01).MAP,SP,DP in the experimental group was extremely increased than those in the control group after 3 days medication(P<0.01).After blood loss,the heart rate of the dogs in the two groups increased significantly,and gradually decreased after medication(P<0.05 or P<0.01).Compared with control group,the heart rate recovered fast in experimental group.These results indicated that treatment of hemorrhagic shock with hetastarch 130/0.4 combined with epinephrine could effectively control the development of shock in dog.