高渗氯化钠羟乙基淀粉40注射液对失血性休克大鼠凝血功能的影响

Influence of blood coagulation during resuscitation with hypertonic sodium chloride hydroxylethy starch 40 in hemorrhagic shock rats

目的观察高渗氯化钠羟乙基淀粉40注射液（高渗晶胶液）对失血性休克大鼠复苏过程中凝血功能的影响。方法16只SD大鼠随机均分为高渗晶胶液复苏组（H组）和复方乳酸钠复苏组（L组），将16只SD大鼠制成失血性休克模型后，分别使用高渗晶胶液和复方乳酸钠各6ml／kg进行复苏，在休克前（T1）、休克后60min（复苏前，T2）及复苏后5min（T3）、30min（T4）、60min（T5）时记录血压，取血浆分别测定出血时间（BT）、凝血时间（TT）、凝血酶原时间（PT）、白陶土部分凝血活酶时间（KPTT）和纤维蛋白原（Fib）。结果两组在T2～T5时BT、TT、PT、KPTT均明显长于T1时（P〈0．05），Fib明显低于T1时（P〈0．05）；H组在T3～T5时BT、TT、PT、KPTT均明显短于L组（P〈0．05）；两组之间Fib在各时点差异无统计学意义。结论高渗晶胶液对失血性休克凝血功能有影响，使BT、TT、PT、KPTT延长，Fib降低，但尚未超过机体的代偿范围。应用高渗晶胶液进行液体复苏时应在临床推荐剂量内，同时加强凝血功能的监测和控制。

Objective To investigate the effect of blood coagulation during resuscitation with hypertonic sodium chloride hydroxylethy starch 40 injection in hemorrhagic shock rats. Methods Sixteen rats were randomly divided into two groups： sodium chloride hydroxylethy starch 40 group （group H）and lactated Ringer＇s solution group （group L）. In group H, the hemorrhagic shock animals received 6 ml/kg hypertonic sodium chloride hydroxylethy starch 40, and in group L with 6 ml/kg lactated Ringer＇s solution. MAP、 BT、TT、 PT 、 KPTT and Fib was measured before shock （T1）, during shock before resuscitation（T2 ）, and 5, 30, 60 min（T3 ,T4 ,T5 ） after fluid resuscitation. Result The instauration of the blood pressure in group H better than group L. BT、TT、PT、KPTT were increased evidently at T2-T5 than at T1 in both groups （P〈0.05）. BT、TT、 PT、KPTT were lower evidently in group H than in group L at T2-T5 （P〈0.05）. But Fib has no obvious difference between two groups. Conclusion BT, KPTT,PT,TT were prolonged and Fib was decreased during resuscitation with sodium chloride hydroxylethy starch, but exceed compensatory airframe range not yet.