限制性输液复苏妊娠失血性休克对血流动力学影响的初步研究

The Initial Study of Limited Fluid Resuscitation on Hemodynamics in Pregnant Period with Hemorrhagic Shock

目的:探讨限制性输液复苏妊娠失血性休克对血流动力学的影响。方法:制作孕兔失血性休克模型,采取限制性输液和传统输液两种不同输液方法复苏孕兔失血性休克,对比两组各时间点的血流动力学变化,休克各时期的失血量、输液输血量以及生存率。结果:休克模型120分钟后,与传统输液组比较,限制性输液组的呼吸、心率降低显著,平均动脉压和中心静脉压升高明显(P<0.01);休克急救期,限制性输液组失血量少于传统输液组(P<0.05),输血输液量更是明显低于传统输液组(P<0.01),复苏后期输液输血量比较,限制性输液组也少于传统输液组,P<0.05;休克后24小时和72小时生存率比较,限制性输液组高于传统输液组,P<0.01。结论:限制性输液能明显改善孕兔的血流动力学,减少失血量以及输液输血量,提高了生存率,是复苏孕兔失血性休克值得进一步研究的理想方法。

Objective： To investigate the effect of limited fluid resuscitation on hemodynamics in pregnant period with hemorrhagic shock.Methods：The model of hemorrhagic shock in pregnant rabbit was established. The hemorrhagic shock of pregnant rabbit was resuscitated by adopting two different transfusion means, limited fluid transfusion and traditional transfusion. The hemedynamic change at various time points, the volume of blood loss, blood/fluid transfusion at various period of shock and survival rate were compared between the two groups. Results： At 120 min after the establishment of shock rnodel, respiration and heart rate decreased while the mean arterial pressure （MAP） and the central venous pressure （CAP） were significantly enhanced in the limited fluid transfusion group than that in traditional resuscitation group （ P 〈 0.01 ）. In the period of shock early treatment, the volume of blood loss in limited fluid resuscitation group was significantly lower than that in traditional resuscitation group （ P〈 0.05）. The volume of blood/fluid transfusion was even lower during this period and at the period Of post - resuscitation （ P 〈 0. 01, P 〈 0.05） in limited transfusion group. The survival rates at 24h and 72h after shock in traditional resuscitation group were lower than those in limited fluid resuscitation group （ P 〈 0.01 ）. Conclusions： Umif.ed fluid resuscitation can distinctly improve the hemodynamics of pregnant rabbit, reduce the volume of blood loss and blood/fluid transfusion, and increase the survival rate which is an ideal resuscitation means for the hemorrhagic shock in pregnant rabbit.