血液稀释对脑外伤合并失血性休克大鼠脑氧代谢的影响

摘要

Objective To investigate the effect of hemodilution on cerebral oxyen metabolism in the rat model of trau-matic brain injury ( TBI) complicated by hemorrhagic shock. Methods A total of 30 male SD rats were randomly divided into 3 groups:TBI group (n=10), shock group (n=10), and TBI and shock group (n=10). SaO2, CaO2, hemoglobin and PbrO2 were determined after model establishment and 15 min, 30 min and 45 min after hemodilution. Results There were no signifi-cant differences of SaO2 at different time points among the three groups (P>0. 05). At 15 min, 30 min and 45 min after fluid infusion, the levels of hemoglobin, CaO2 and PbrO2 decreased significantly in shock group and shock and TBI group ( P 0．05)。补液完成后15、30及45 min时,单纯休克组及脑外伤合并休克组血红蛋白、血氧含量及脑组织氧分压较造模成功后明显下降(P<0．05),但不在输血范围,且以补液后15 min下降最明显,30及45 min后恢复；造模成功后脑外伤合并休克组脑组织氧分压均低于其余两组(P<0．05,P<0．01)；单纯休克组及脑外伤合并休克组与脑外伤组补液后相同时点比较,仅脑组织氧分压差异有统计学意义(P<0．05,P<0．01),且脑外伤合并休克组较单纯休克组下降更明显(P<0．01)。结论颅脑外伤合并失血性休克后即使正规补液也可能会加重缺氧性脑损伤。