不同液体复苏方式对失血性休克大鼠血流动力学的影响

Effects of Different Means of Resuscitation on Changes of Hemodynamic Values in Rats with Hemorrhagic Shock

目的:探讨不同液体复苏对失血性休克大鼠血流动力学的影响及机制。方法:Wistar大鼠40只,随机分为5组:假手术组、休克组、乳酸林格液(RL)复苏组、羟乙基淀粉(HES)复苏组、自身血液(BL)复苏组,每组8只,建立失血性休克大鼠模型。在失血性休克大鼠模型复制成功后1h给予对应液体复苏2h。观察并记录各组大鼠的血流动力学变化:收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、呼吸频率(RR)和心率(HR)。结果:三组液体复苏组休克时的SBP、DBP、MAP均较休克前低,HR、RR较休克前明显加快(P<0.05)。RL复苏组各时间点SBP、DBP、MAP明显低于休克前(P<0.05)。HES组、BL组复苏各时间点SBP、DBP、MAP与休克前相近(P>0.05),但明显高于RL组。RL组各时间点RR明显快于休克前(P<0.05),HES组、BL组复苏各时间点RR与休克前相近(P>0.05),但明显低于RL组。RL组复苏60min、90min、120min的HR明显快于休克前(P<0.05),HES组、BL组苏各时间点HR同休克前相近(P>0.05),但60min、90min、120min的HR明显低于RL组(P<0.05)。结论:三组不同液体复苏,自身血液复苏和羟乙基淀粉复苏二者效果相当,均较乳酸林格液能显著增加有效循环血容量,是较理想的失血性休克的复苏液体。

Objectives： The study was aimed to investigate the effects of different means of resuscitation on changes of hemodynamic values and to clarify its mechanism in hemorrhagic shock rats. Methods： 40 Wistar rats were randomly divied into 5 groups： sham group, shock group,lactated Ringers Solution （RL） group,Hydroxylethy starch （HES） group and autotransfusion group with eight rats per group. Each group was subjected to hemorrhagic shock for lh, fellowed by resuscitation with lactated Ringers Solution, Hydroxylethy starch, and autotransfusion for 2h.Changesof hemodynamic valuers of various rats were observed and recorded. The hemodynarnic values included systolic blood pressure（SBP）,diastolic blood pressure（DBP）, mean arterial blood pressure（MAP）, respiratory rate（RR） and heart rate（HR）, Results： On the time of shock forwith, SBP, DBP and MAP of the three groups were lower and the HR, RR were faster as compared with foundation values（P〈0.05）. SBP, DBP and MAP after resuscitation of RL group were lower compared with foundation values （P〈0.05）, SBP, DBP and MAP after resuscitation of liES group and BL group were approached to foundation value （P〉0.05）, but higher than RL group （P〈0.05）. RR of RL group were faster as compared with foundation values （P〈0.05）. RR after resuscitation of liES group and BL group were approached to foundation valu e（P〉0.05）, but lower than RL group（P〈0.05）. HR after resuscitation for 60, 90 and 120 minutes of RL group were faster than foundation values（P〈0.05）. HR after resuscitation for 60, 90 and 120 minutes of liES group and BL group were approached to foundation value（P〉0.05）, but lower than RL group（P〈0.05）. Conclusions： with three different means of resuscitation, Hydroxylethy starch（HES） group and autotransfusion group have the same effects, compared with Ringers Solution, they can increase effective circulating bolld volume and would be better means of resuscitation in rats with hemorrhagic shock.