霍姆复合液对创伤性休克兔凝血功能及血清钙的影响

Effects of Hypertonic Sodium Chloride Hydroxyethyl Starch 40 injection on coagulation function and Ca^(2+) change of traumatic shock rabbit

目的探讨霍姆复合液对创伤性休克兔限制性液体复苏过程中凝血功能及Ca2+的影响。方法健康新西兰白兔54只,随机分成生理盐水组(NS)、霍姆复合液组(HHS)、2∶1晶胶复合液组(NHS)共三组,每组各18只,分别于休克时(T_0),休克后30 min(T_1)、60 min(T_2)、90 min(T_3),测量凝血酶原(PT)、部分凝血活酶时间(APTT)、纤维蛋白原含量(Fbg)、凝血酶时间(TT)、国际标准化比率(INR)及血钙浓度,分析凝血功能及血钙水平的变化。结果三组液体复苏后PT与T0时间相比P<0.05,差异有统计学意义;三组液体复苏后APTT与T_0时间APTT相比均P<0.05,差异有统计学意义;三组液体复苏后Fbg在T_1、T_2、T_3时间与T_0时间相比均P<0.05,差异有统计学意义;霍姆复合液组较生理盐水组、2∶1晶胶复合液组可明显改善PT、APTT、Fbg水平,差异有统计学意义(P<0.05)。结论采用霍姆复合液能明显改善低灌注和凝血功能,对于创伤性休克的复苏具有一定的指导意义。

Objective Effect of limited fluid resuscitation on blood coagulation function and Ca^(2+) change in traumatic shock rabbits. Methods 54 healthy rabbits in total were divided into Normal Saline( NS) group,Hypertonic Sodium Chloride Hydroxyethyl Starch 40( HHS) group and 2 time Normal Saline +1 time Hydroxyethyl Starch 40( NHS) group randomly with 18 in every group. PT,APTT,Fbg,TT,INR and Ca^(2+) change at various time points were compared and studied in the group and between the different groups.Result Three groups of liquid recovery after PT compared with T0 time P < 0. 05,the difference was statistically significant; Three groups of liquid recovery after APTT compared with T_0 time P < 0. 05,the difference was statistically significant; Three groups of liquid recovery after Fbg in T_1,T_2,T_3 time compared with T_0 time all P < 0. 05,the difference was statistically significant; Compared with NS and NHS,HHS can obviously improve the PT,APTT and Fbg levels,the difference was statistically significant( P < 0. 05).Conclusion Hypertonic Sodium Chloride Hydroxyethyl Starch 40 injection can improve low perfusion and blood coagulation function obviously.