摘要
目的:研究血定安(gelofusion)对重症非控制性失血性休克低压复苏期间脂质过氧化反应的影响。方法:12只犬随机等分为平衡盐液(LR)组(组Ⅰ)和血定安(GF)组(组Ⅱ)。采用非控制性失血性休克模型,当MAP降到20mmHg时,两组分别输注LR或GF并调节输液速度使MAP维持在35~40mmHg。于放血前(T_(1))、休克至MAP 40mmHg(T_(2))、20mmHg(T_(3))及复苏后30min(T_(4))、60min(T_(5))、120min(T_(6))时测血SOD和MDA,记录HR、MAP、CO、CI,复苏120min时计腹腔失血量。结果:组Ⅰ输液量及腹腔失血量均显著大于组Ⅱ(P<0.01,和P<0.05)。再灌注后组Ⅰ血SDO活性进行性下降,血MDA迅速上升,于T_(5)时显著高于组Ⅱ,而组Ⅱ再灌注期MDA与缺血期(T_(3))比较差异无显著性,且SOD呈上升趋势,其中T_(6)SOD值显著高于组Ⅰ(P<0.05)。再灌注期间组ⅡMAP较组Ⅰ稳定。120min组Ⅰ存活率低于组Ⅱ(P<0.05)。结论:与LR比较,GF低压复苏重症非控制性失血性休克能显著降低再灌注期脂质过氧化反应程度,维持较稳定的血流动力学,降低动物死亡率。
Objective:To study the effect of gelofusion on lipid peroxidation during hypotensive resuscitation of uncontrolled hemorrhagic shock.Methods:12 dogs were randomly divided into two groups:lactated ringers solution(GroupⅠ)and gelofusion(GroupⅡ),uncontrolled hemorrhagic shock animal model was prepared.Infused LR and GF respectively when MAP fell to 20 mmHg,and infusion rate was adjusted to keep MAP at 35~40 mmHg.SOD and MDA level were determined before bleeding(T_(1)),MAP at 40 mmHg(T_(2)),20 mmHg(T_(3))and 30 min(T_(4)),60 min(T_(5)),120 min(T_(6))after reperfusion respectively.HR,MAP,CO and CI were also recorded.The blood loss of abdominal cavity 120 min after resuscitation was measured.Results:Fluid administration or blood loss of abdominal cavity of GroupⅠwas significantly higher than that of GroupⅡ(P<0.01 and P<0.05,respectively).In GroupⅠ,SOD decreased and MDA increased after reperfusion,MDA was significantly higher than that of GroupⅡat T_(5)(P<0.05),In GroupⅡ,there were not statistical difference between MDA at T_(3)and MDA at postreperfusion,SOD increased and was significantly higher than that of groupⅠat T_(6)(P<0.05),the stability of MAP and survival rate are better than GroupⅠ.Conclusion:Compare with LR,GF can significantly inhibit lipid peroxidation of reperfusion during hypotensive resuscitatin of uncontrolled hemorrhagic shock,keep stable hemodynamic,reduce animals mortality.
作者
吴灵翕
黄海波
曹经山
夏中元
Wu Lingxi;Huang Haibo;Cao Jingshan(Department of Anesthesiology,First Affiliated Hospital,Hubei Medical University,Wuhan 430060,China)
关键词
急性失血性休克
血定安
脂质过化反应
shock
plasma substitutes
resuscitation
lipid peroxidation
