高渗盐水对兔多发伤并失血性休克限制性液体复苏效果的研究

Study on the Effect of Restrictive Fluid Resuscitation with Multiple Osmotic Saline in Rabbits with Hemorrhagic Shock

目的:探讨高渗盐水对兔多发伤并失血性休克限制性液体复苏的效果。方法:建立多发伤致休克兔模型,通过不同液体进行限制性复苏,观察并比较各组别复苏液使用量、凝血功能、血乳酸、剩余碱变化,以及肺、肾脏病理损伤变化。结果:在不同时间段,各组动物心率、平均动脉压无显著差异,P>0.05;与生理盐水组相比,3.0%组及7.5%组不同时间点血乳酸、碱剩余动态变化、凝血功能明显优于生理盐水组及羟乙基淀粉组,差异有统计学意义,P<0.05;3.0%组、7.0%组在各个时段的补液量均小于生理盐水组,差异有统计学意义,P<0.05;3.0%组及7.5%组之间复苏各时间点血乳酸、碱剩余、凝血功能以及补液量对比无明显差异,P>0.05。结论:早期应用高渗盐水液体复苏能显著改善兔多发伤并失血性休克的状态,疗效显著,且补液量较低,对于临床应用具有指导意义。

Objective:To investigate the effect of hypertonic saline on restrictive fluid resuscitation in rabbits with multiple injuries and hemorrhagic shock.Methods:A rabbit model of multiple shock-induced shocks was established.Restricted resuscitation was performed with different fluids to observe and compare the use of resuscitation fluid,coagulation function,changes in blood lactate and residual alkali,and changes in lung and kidney pathology.Results:There was no significant difference in heart rate and mean arterial pressure between different groups at different time points(P>0.05);compared with the saline group,the changes of blood lactate and alkali residue at different time points in the 3.0%and 7.5%groups were significantly better than those in the saline group and the hydroxyethyl starch group(P<0.05);the rehydration volume of each group in the 3.0%group and 7.0%group was smaller than that of the saline group(P<0.05);there was no significant difference in blood lactate,alkali excess,coagulation function,and fluid volume at each time point between the 3.0%and 7.5%groups(P>0.05).Conclusion:Early application of hypertonic saline liquid resuscitation can significantly improve the state of multiple traumatic and hemorrhagic shock in rabbits.The curative effect is significant and the volume of fluid replacement is low,which has guiding significance for clinical application.