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目的探讨6%羟乙基淀粉溶液(6%HES)进行液体复苏对毒血症犬呼吸动力学的影响。方法健康杂种犬15只,随机分为3组:对照组(n=5)即假模型组,腹腔只注入生理盐水,没有毒血症,用乳酸林格溶液(LR)作为输注液体;LR组(n=5)腹腔注入肠液,毒血症后用LR作为复苏液体;HS组(n=5)腹腔注入肠液,毒血症后用6%HES作为复苏液体。在毒血症前及后0.5、1、4、8h测定犬的平均动脉压(MAP)、心输出量(CO)等血流动力学指标。同时记录吸气峰压(PIP)、呼吸机作功(Wob)、动态顺应性(Cdyn)及无效腔比率(Vd/Vt)等呼吸动力学指标值。记录总尿量及体质量,计算肺湿/干比。结果 MAP、CO在毒血症诱导后4h较基础值明显下降,毒血症诱导后8h下降更为明显,其中HS组MAP、CO明显高于其他组(P<0.05)。毒血症诱导后4、8h,PIP、Wob、Cdyn明显大于基础值,HS组PIP、Wob明显小于其他组(P<0.05);肺湿/干比HS组明显小于LR组(P<0.05);Vd/Vt明显增大,HS组明显小于其他组(P<0.05)。结论 6%HES更有利于毒血症犬血流动力学维持,保护了肺功能。
Objective To investigate the effect of 6% hydroxyethyl starch solution (6% HES) on respiration dynamics in dogs with sepsis. Methods Fifteen healthy mongrel dogs were randomly divided into three groups: the control group (n = 5), the model group. The rats in the control group were injected with normal saline only without any toxemia. Lactate Ringer’s solution (LR) The rats in group HS (n = 5) were given intraperitoneal injection of intestinal fluid and LR was used as the resuscitation fluid after septicemia. HS group (n = 5) was injected intraperitoneally with 6% HES after resuscitation. The hemodynamics indexes such as mean arterial pressure (MAP) and cardiac output (CO) were measured at 0.5, 1, 4, and 8 h before and after. The PIP, Wob, Cdyn and Vd / Vt were also recorded. Total urine output and body weight were recorded and lung wet / dry ratio was calculated. Results The levels of MAP and CO decreased significantly at 4h after induction of sepsis, and decreased more obviously 8h after induction of sepsis. The MAP and CO in HS group were significantly higher than those in other groups (P <0.05). PIP, Wob and Cdyn at 4 and 8 hours after induction of toxemia were significantly higher than those at baseline, PIP and Wob in HS group were significantly lower than those in other groups (P <0.05) ; Vd / Vt increased significantly, HS group was significantly less than other groups (P <0.05). Conclusions 6% HES is more conducive to the maintenance of haemodynamics in canine beagle dogs and protects lung function.