失血性休克状态下肢体缺血再灌注影响休克发展的研究

Effect of postischemic limb reperfusion on developmental course of hemorrhagic shock

目的：研究失血性休克状态下骨骼肌缺血再灌注对休克发展的影响。方法：雌性家兔１２只，随机等分为休克对照组（Ⅰ组）和休克伴双后肢缺血再灌注组（Ⅱ组）。戊巴比妥钠麻醉，气管切开，自主呼吸，并全身肝素化。经左颈外静脉，按１ｍｌ·ｋｇ－１·ｍｉｎ－１的速度放血５分钟，停５分钟，以左颈总动脉ＭＡＰ达４．０±０．２ｋＰａ为休克开始，此时Ⅱ组阻断腹主动脉末端，９０分钟后松开。结果：休克后１２０分钟，血中ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α、乳酸、酸性磷酸酶及Ｍｇ２＋，Ⅱ组均显著高于Ⅰ组，而休克９０分钟时，各值两组间无显著性差异。结论：失血性休克状态下肢体骨骼肌缺血再灌注可能对休克的发展产生不利影响。

Objective:To investigate effect of postischemic limb reperfusion on developmental course of hemorrhagic shock Method:12 female rabbits,anesthetized with pentobarbital sodium,were divided into shock control group (n=6) and treatment (T) group (n=6) After heparinization hemorrhagic shock model was induced by the bleeding at of 1 ml·kg -1 ·min -1 via left external jugular vein at 5 minute interval with MAP being lowered to 4 2±0 2 kPa The occlusion of distal portion of abdominal aorta lasted 90 minutes immediately following the shock in group T Result:Arterial TxB 2 level,the TxB 2 to 6 keto PGF 1α concentration ratio,concentration of both lactic acid and magnesium,and activities of acid phosphatase were significantly higher in group T than those in control group 120 minutes following shock,but none of the above parameters was signifcantly different between the both groups at 90 minutes following shock Conclusion:The postischemic reperfusion of limb skeletal muscle in hemorrhagic shock have some bad effects on the developmental course of the shock and more attension should be paid to the hemorrhagic shock with tourniquent ischemia of limb