不同液体输注对犬失血性休克时的血流动力学、氧转运及血管外肺水的影响

Resuscitation fluids for the treatment of hemorrhagic shock in dogs:Effects on hemodynamics,oxygen transport and extravascular lung water

目的:以犬为实验对象研究不同液体输注对失血性休克时的血流动力学、氧转运及血管外肺水的影响。方法:选择成年健康犬15只,静脉麻醉后通过动脉放血至平均动脉压4.67kPa制作失血性休克模型,继分别以乳酸钠林格氏液、全血及多聚明胶等三种液体输注复苏,以PAWP值恢复至2.0kPa为输血输液终点,观察血流动力学、氧转运和血管外肺水等各指标的变化。结果:乳酸钠林格氏液组的血流动力学各项指标虽然于复苏即刻恢复至对照水平,但复苏后30分钟CI、SVI即降至低于对照水平,而全血组和多聚明胶组于复苏即刻及复苏后30分钟均可明显恢复血流动力学各指标,并且多聚明胶组在CI、SVI、SVRI等各指标较其它两组为好。结论:在失血性休克输液治疗过程中,胶体液较晶体液更为有效,且对血管外肺水影响较小。多聚明胶能更有效地改善血流动力学状态,全血能明显增加氧转运。

Objective:To investigate the effects of resuscitation with different fluids on hemodynamics,oxygen transport and extravascular lung water after acute hemorrhage in dogs. Method:Fifteen dogs were anesthetized and bled to a mean arterial pressure of 4.67 kPa to develop the hemorrhagic shock model.Then the animals were infused with one of three randomly selected fluid:lactated Ringer's solution, blood and polygeline.The terminal point of fluid resuscitation was at the level of PAWP of 2.0 kPa. Hemodynamics, oxygen transport and extravascular lung water values were measured. Result:colloids fluids infusion has more better efficacy and less extravascular lung water than crystalloids fluids infusion in hemorrhagic shock resuscitation,and polygeline infusion could restore hemodynamics better, meanwhile blood infusion could restore oxygen transport better.