高渗盐水在未控制出血性休克大鼠限制性液体复苏中应用的研究

摘要

目的：观察高渗盐水对未控制出血性休克大鼠限制性液体复苏的影响。方法根据复苏方法的不同，将30只SD大鼠随机分为假手术组、等渗复苏组、高渗复苏组，每组10只。观察各组大鼠各时间点的存活率，比较各组大鼠的出血量、输液量、90 min时pH值及碱缺失（BD）值和血浆MDA含量、总SOD活力、TNF-α含量。结果实验前各组大鼠的体重、平均动脉压（MAP）、心率（HR）、血液pH值、BD值和血浆MDA含量、总SOD活力、TNF-α含量无显著性差异。实验后，等渗复苏组和高渗复苏组大鼠的存活率、出血量、90 min时pH值及BD值无差别，等渗复苏组的输液量明显高于高渗复苏组（P<0.01）。和等渗复苏组相比，高渗复苏组的大鼠血浆MDA和TNF-α含量明显下降，总SOD活力升高。结论7.5%高渗盐水限制性液体复苏可以明显减少液体用量，减少氧自由基的产生，减轻缺血再灌注损伤，并减少炎症因子的产生，但未能改善出血量和存活率。%Objective The study is aim to investigate the effects of hypertonic saline solution resuscitation in uncontrolled hemorrhagic shock rat. Methods 30 SD rats were randomly divided into three groups which include shame-operated group, hypertonic saline solution resuscitation group and isotonic saline solution resuscitation group according to types of fluid resuscitation. The amount of bleeding, dosage of infusion, and survival rate were observed. Value of pH and BD as well as concentration of MDA, SOD, and TNF-αin serum were detected on 90min. Results There is no difference among weight, mean arterial pressure, heart rate, the value of pH and BD and concentration of MDA, SOD, and TNF-αin serum of rats before the experiment. In the experiments groups, no significant difference were found between survival rate, amount of bleeding, value of pH and BD of the two groups. Dosage of infusion of isotonic saline solution resuscitation group was dramatically higher than those in hypertonic saline solution resuscitation group (P<0.01). The concentration of MDA and TNF-αin serum in isotonic saline solution resuscitation group was higher than in hypertonic saline solution resuscitation group (P<0.01) and the concentration of SOD in isotonic saline solution resuscitation group was significantly reduced compared with hypertonic saline solution resuscitation group (P<0.01). Conclusion Resuscitation with hypertonic saline solution had similar effects on the amount of bleeding as well as animal survival, but it could obviously reduce the dosage of infusion, decrease the formation of oxygen free radicals and injury caused by ischemia-reperfusion. It also could restrain inflammatory reaction.