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目的:探讨不同液体复苏对失血性休克大鼠血流动力学的影响及机制。方法:Wistar大鼠40只,随机分为5组:假手术组、休克组、乳酸林格液(RL)复苏组、羟乙基淀粉(HES)复苏组、自身血液(BL)复苏组,每组8只,建立失血性休克大鼠模型。在失血性休克大鼠模型复制成功后1h给予对应液体复苏2h。观察并记录各组大鼠的血流动力学变化:收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、呼吸频率(RR)和心率(HR)。结果:三组液体复苏组休克时的SBP、DBP、MAP均较休克前低,HR、RR较休克前明显加快(P<0.05)。RL复苏组各时间点SBP、DBP、MAP明显低于休克前(P<0.05)。HES组、BL组复苏各时间点SBP、DBP、MAP与休克前相近(P>0.05),但明显高于RL组。RL组各时间点RR明显快于休克前(P<0.05),HES组、BL组复苏各时间点RR与休克前相近(P>0.05),但明显低于RL组。RL组复苏60min、90min、120min的HR明显快于休克前(P<0.05),HES组、BL组苏各时间点HR同休克前相近(P>0.05),但60min、90min、120min的HR明显低于RL组(P<0.05)。结论:三组不同液体复苏,自身血液复苏和羟乙基淀粉复苏二者效果相当,均较乳酸林格液能显著增加有效循环血容量,是较理想的失血性休克的复苏液体。
Objective: To investigate the effect and mechanism of different fluid resuscitation on hemodynamics in hemorrhagic shock rats. Methods: Forty Wistar rats were randomly divided into five groups: sham operation group, shock group, lactic acid Ringer’s solution (RL) resuscitation group, hydroxyethyl starch (HES) resuscitation group and self blood BL group Group 8, the establishment of hemorrhagic shock rat model. In the hemorrhagic shock rat model was successfully replicated 1h to give the corresponding fluid recovery 2h. The hemodynamic changes of SBP, SBP, DBP, MAP, RR and HR were observed and recorded. Results: The SBP, DBP and MAP in shock resuscitation group were lower than those before shock in shock resuscitation group, HR and RR were significantly higher than those before shock (P <0.05). SBP, DBP and MAP in RL recovery group were significantly lower than those before shock (P <0.05). SBP, DBP, MAP of HES group and BL group were similar to those before shock (P> 0.05), but significantly higher than those of RL group. The RR of RL group was significantly faster than that of shock group at each time point (P <0.05). The RR of HES group and BL group at each time point was similar to that before shock (P> 0.05), but significantly lower than that of RL group. HR of HR group at 60min, 90min and 120min after RL was significantly higher than that before shock (P <0.05). HR of HES group and BL group at each time point was similar to that before shock (P> 0.05), but HR at 60min, 90min and 120min was significantly higher Lower than RL group (P <0.05). Conclusion: The three groups of different liquid resuscitation, blood resuscitation and hydroxyethyl starch resuscitation both the effect is comparable to lactated Ringer ’s fluid can significantly increase the effective circulating blood volume, is the ideal recovery of hemorrhagic shock fluid.