创伤性失血性休克液体复苏救治方案的动物模型研究

Animal-model research for the aid-treatment of traumatic hemorrhagic shock with fluid resuscitation program

目的探讨创伤性失血性休克(traumatic hemorrhagic shock,THS)液体复苏救治方式并预评估其临床价值。方法选择新西兰兔18只,通过急性失血方式建立收缩压下降曲线,形成THS模型,测定收缩压基础值(T_1),记录收缩压降至基础值2/3(T_2),基础值1/2(T_3),基础值1/3(T_4)的时间;实验兔随机分为实验组A、B、C共3组,分别按(1)^(3)复苏成分组合方案输注,并记录A^C实验组收缩压由T4达到T_2位置时间。结果收缩压下降T_1~T_2及T_2~T4段时间差异有统计学意义(P<0.05),T_2~T_3及T_3~T_4段时间差异无统计学意义(P>0.05);输注后各组实验兔收缩压由T4升至T_2位置时间分别为(192.500±21.886)s、(392.000±180.191)s和(198.000±11.533)s,其中A与B组间差异有统计学意义(P<0.05),A与C组间差异无统计学意义(P>0.05)。结论选择快速失血形成收缩压下降曲线方式可建立THS模型,液体复苏救治可选择收缩压基础值2/3位置作为临界血压维持点,根据由收缩压基础值1/3升到2/3位置时间优选复苏成分组合,其中5%氯化钠、羟乙基淀粉130/0.4氯化钠注射液、全血可作为院前THS液体复苏救治首选方案。

Objective To explore the fluid resuscitation way and preevaluate its clinical value for traumatic hemorrhagic shock （THS）. Methods The model of THS was eatablished with gradient decerease of systolic blood pressure in 18 New zealand rabbits. The time wer measured on the different phase of shock,i.e. when the systolic pressures were 2/3（T2）,1/2（T3）,1/3（T4） of the basis systolic blood pressure. The rabbits were randomly divided into experimental group A,B,C,respectively according to （1）-（3） composition recovery program received infusion, then were recorded the time of systolic blood from T2 position to T4 one. Results There were significant differences in T1-T2 and T2-T4 period of systolic blood pressure decreased（P＆lt;0.05）,and in T2-T3 and T3-T4 period so did,too （P＆gt;0.05）. Each group after infusion systolic pressure was raised from the T4 to T2 position time as 192.500 ＆#177;21.886 s,392.000 ＆#177;180.191 s and 198.000 ＆#177;11.533 s,wherein between group A and B the difference was significant（P＆lt;0.05）,and between group A and C was no significant（P＆gt;0.05）. Conclusion Selecting systolic blood pressure decrease formed by rapid hemorrhagic can establish THS model for fluid resuscitation aid baseline of systolic blood pressure at its 2/3 point can be remained critical point;a preferably recovery composition is chosen according to systolic blood pressure from the baseline 1/3 to 2/3 position time,which consists of 5% sodium chloride,hydroxyethyl starch 130/0.4 sodium chloride injection,whole blood could be used as the preferred solution to prehospital treatment.