损伤控制性复苏对家兔急性重度失血性休克的影响

Damage control resuscitation on the rabbits undergone acute severe hemorrhagic shock

目的:研究损伤控制性复苏对急性重度失血性休克兔的血流动力学、凝血功能、全身炎症反应和多器官功能障碍的影响。方法:制备急性重度失血性休克家兔模型,按复苏方法不同随机分成传统的液体复苏组、损伤控制性复苏组,建模60min后开始复苏,各组检测心率、血压、凝血功能变化以及血肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、丙氨酸转氨酶(ALT)、肌酐(Cr)、肌酸激酶同工酶(CK-MB)的变化。结果:损伤控制性复苏较传统的液体复苏可显著改善凝血功能异常,降低炎症细胞因子(TNF-α、IL-6);减轻心肺肝肾各器官功能障碍。结论:损伤控制性复苏能减轻急性重度失血性休克引起的凝血功能异常、全身炎症反应、多器官功能障碍,有临床推广应用价值。

Objective：To study the effects of damage control resuscitation on the haemodynamics, coagulation function, systemic inflammatory response and muhiple organ dysfunction in rabbits undergone acute severe hemorrhagic shock. Methods ： After preparation of the animal models of acute severe hemorrhagic shock, 24 rabbits were evenly randomized into groups of A by conventional fluid-resuscitation and B by damage control resuscitation. The resuscitation was introduced 60 min after the preparation of the models, with measurement of the heart rate, blood pressure, examination of the coagulation function,TNF-α, IL-6, ALT, Cr and CK-MB variation. Results：Damage control resuscitation could significantly im- prove the coagulation dysfunction, inhibit the inflammatory cell cytokine （TNF-α, IL-6） and lessen the degree of the organ damage in heart,lung, liver and kidneys as compared with the conventional fluid-resuscitation. Conclusion：Damage control resuscitation may modify the abnormal coagulation resulted from acute severe hemorrhagic shock, suppress the systemic inflammatory response and reduce the degree of muhiple organ damage, which is worthy of wider application in clinic.