低血压复苏治疗出血未控制的创伤失血性休克的实验研究

STUDY ON LOW BLOOD PRESSURE RESUSCITATION IN TREATMENT OF UNCONTROLLED TRAUMATIC HYPOVOLEMIC SHOCK IN RATS

探讨低血压复苏在出血未控制的创伤失血性休克治疗中的意义。建立创伤性休克动物模型 ,随机分为不复苏组、传统复苏组和低压复苏组 ,于创伤前后测定凝血酶原时间、部分凝血活酶时间及肝、小肠、骨骼肌的组织氧分压变化 ,监测生命体征 ,记录存活时间。结果显示 ,传统复苏组休克期出血量显著多于其他两组 ,凝血酶原时间、部分凝血活酶时间延长 ,而低压复苏组可显著改善组织氧分压 ,延长存活时间。提示低血压复苏治疗更能改善出血未控制的创伤性休克大鼠的预后。

The aim of this study was to investigate the significance of low blood pressure (permissive hypotension) resuscitation in the treatment of uncontrolled traumatic shock. A traumatic shock animal model was replicated in Sprague Dawlay rats, the animals were randomly devided into non resuscitation group, traditional resuscitation group and low blood pressure resuscitation group. Prothrombin time(PT), activated pactial thromboplastin time(APTT) and oxygen partial pressure in tissues, including skeletal muscles, liver and small intestine, were determined before and after shock. Meanwhile, hemodynamic parameters of the rats and their survival time were monitored and recorded. The data showed that there were statistically significante difference in PT, APTT and amount of blood loss during shock between traditional resuscitation group and the other two groups. Low blood pressure (permissive hypotension) resuscitation could significantly improve oxygen partial pressure in tissues and prolong the mean survival time. The data suggested that low blood pressure resuscitation was a more rational strategy to improve the prognosis in rats with uncontrolled traumatic shock than traditional resuscitation strategy.