输液温度对失血性休克模型兔肝功能的影响

Effects of fluid temperature on hepatic function in the rabbit model of hemorrhagic shock

目的观察输注不同温度溶液后对失血性休克复苏模型兔肝功能的影响,探讨液体复苏时不同温度溶液对减轻肝脏损害的作用。方法选择健康新西兰雄兔30只,随机分为4组进行手术插管及制作休克模型,在休克模型稳定30min后按相同速度相同液量分别给予低温(10.7±1.6)℃、常温(20.6±1.3)℃及温热(39.5±1.3)℃平衡液和自体血;在休克前、休克及液体复苏1h、2h和4h监测丙氨酸氨基转移酶、门冬氨酸氨基转移酶、血清总蛋白和白蛋白水平。结果失血性休克可以导致肝功能损害,休克时各实验组丙氨酸氨基转移酶及门冬氨酸氨基转移酶均升高,复苏过程中温热组和低温组均低于常温组,以低温组效果更明显。休克后各实验组总蛋白和白蛋白均下降,但各组间的差异无统计学意义。结论失血性休克能引起肝功能异常,丙氨酸氨基转移酶及门冬氨酸氨基转移酶升高;液体复苏时低温溶液和温热溶液有助于改善肝功能,低温溶液效果最佳。

Objective To observe the effect of infusion at different fluid temperatures on hepatic function in the rabbit model of hemorrhagic shock and resuscitation. Methods After the rabbit hemorrhagic shock model was successfully duplicated, the 30 rabbits were randomized to four groups, receiving hypothermic fluid (10.7±1.6℃), normothermic fluid (20.6±1.3℃), hyperthermic fluid (39.5±1.3℃) and autoblood. The ALT, AST, serum albumin and serum total protein were examined at baseline, shock and resuscitation phases (1 h, 2 h and 4 h). Results Hemorrhagic shock could cause the damage of hepatic function, resulting in the elevation of AST and ALT. At resuscitation, AST and ALT in the hypothermic and hyperthermic groups were lower than that in the normothermic group and the hypothermic fluid had best effect. Post-shock the total protein and albumin went down, without significant differences statistically between the groups. Conclusion Hemorrhagic shock may result in abnormal hepatic function and elevation of ALT and AST. Infusion of hypothermic fluid or hyperthermic fluid at resuscitation helps the improvement of hepatic function and the former is best.