低温扩容对大鼠失血性休克的治疗效果

The effects of hypothermia and fluid resuscitation on survival of hemorrhagic shock in rats

目的 探讨失血性休克期间给予低温 ,以及在复苏期间应用扩血管药物增加血容量对大鼠失血性休克的治疗效果。方法 将 35只Wistar雄性大鼠随机分为 4组 :低温扩容组 (SNP ,10只 ) ,休克期直肠温 32 .0℃± 0 .5℃ ,复苏期回输血液后 ,输注 1倍失血量的乳酸林格液 ;低温组 (OT ,10只 ) ,休克期直肠温 32 .0℃± 0 .5℃ ,复苏期只回输血液 ;常温组 (NT ,10只 ) ,休克期直肠温 38.0℃± 0 .5℃ ;对照组 (Con ,5只 ) ,不放血也不给予低温和复苏。实验中持续监测平均动脉压 (MAP) ,在 0min、失血末、休克末和复苏末测血气和乳酸值 ,记录大鼠生存时间和 72h生存率。结果 休克期OT组及SNP组MAP显著高于NT组 (P <0 .0 5 )而低于Con组 (P <0 .0 5 ) ,复苏期SNP组和Con组MAP显著低于OT组 (P <0 .0 5 )。失血末 ,与Con组比其余各组乳酸值均显著升高 (P <0 .0 5 ) ,BE值显著降低 (P<0 .0 5 ) ,各组间pH值无差异 ;休克末 ,两低温组乳酸值与Con组比无显著差异 (P >0 .0 5 ) ,而BE仍低于Con组 (P<0 .0 5 ) ,常温组乳酸值和BE显著低于其余 3组 (P <0 .0 5 ) ,两低温组和常温组pH值显著低于Con组 (P <0 .0 5 ) ,而常温组pH值又显著低于两低温组 (P <0 .0 5 ) ;复苏末 ,两低温组乳酸值、BE及pH值与Con组比无显著差异 (P >

Objective To explore the effects of hypothermia and fluid resuscitation on survival of hemorrhagic shock (HS) in rats.Methods Thirty-five rats were randomly divided into four groups.In SNP group,there were ten rats with rectal temperature 32℃±0.5℃ during the period of HS,and they were resuscitated with blood and Lactated Ringer's solution.In OT group,there were ten rats with rectal temperature 32℃±0.5℃ during the period of HS,and they were resuscitated with blood alone.In NT group,there were ten rats with rectal temperature 38℃±0.5℃ during the period of HS.In Con group,there were five rats without HS,hypothermia and fluid resuscitation.Mean arterial pressure (MAP) was monitored continuously,arterial blood gas and lactic acid (LA) were measured at 0min,the end of blood withdrawal,the end of HS and the end of resuscitation,and survival time and survival rate of 72h were recorded.Results MAP in hypothermic groups was significantly higher than group NT and lower than group Con during HS (P< 0.05).In group SNP and group Con MAP was significantly lower compared with group OT during the period of resuscitation.At the end of blood withdrawal,LA was higher and BE was lower in group SNP,group OT and group NT compared with group Con(P< 0.05),and there was not significant change in pH.At the end of HS,LA in group SNP and group OT was improved (P>0.05 compared with group Con) and BE was still lower (P<0.05 compared with group Con).LA and BE in group NT became worse (P<0.05 compared with the other three groups).At the end of resuscitation,there were no significant in LA,BE and pH among group SNP,group OT and group Con (P>0.05 ).In group SNP,group OT,group NT and group Con,the survival rate of 72h was 30%,80%,0%,100% respectively,and survival time was 33.35h±28.34 h,63.90h±17.09h,0.98h±0.32h and 72.00h±0.00h,respectively.Group NT was significantly lower compared with the other three groups (P<0.05 ),group SNP was lower than group OT and group Con (P<0.05),and there was no significant difference between group OT and group Con (P>0.05).Conclusion Hypothermia during hemorrhagic shock prolongs survival time,and infusing large volume of crystalloid fluid during resuscitation reduces survival in rats.