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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 2 0mmHg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 (T1)、休克至MAP 40mmHg (T2 )、2 0mmHg (T3 )及复苏后 30min (T4 )、6 0min (T5)、12 0min (T6)时测血SOD和MDA ,记录HR、MAP、CO、CI,复苏 12 0min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 .0 1,和P <0 .0 5 )。再灌注后组Ⅰ血SDO活性进行性下降 ,血MDA迅速上升 ,于T5时显著高于组Ⅱ ,而组Ⅱ再灌注期MDA与缺血期 (T3 )比较差异无显著性 ,且SOD呈上升趋势 ,其中T6SOD值显著高于组Ⅰ (P <0 .0 5 )。再灌注期间组ⅡMAP较组Ⅰ稳定。 12 0min组Ⅰ存活率低于组Ⅱ (P <0 .0 5 )。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 low pressure resuscitation in severe uncontrolled hemorrhagic shock. Methods: Twelve dogs were randomly divided into Balance Saline (LR) group (Group Ⅰ) and Xuedingan (GF) group (Group Ⅱ). Using uncontrolled hemorrhagic shock model, when MAP dropped to 20mmHg, two groups were infused with LR or GF and infusion rate was adjusted to maintain MAP at 35 ~ 40mmHg. The blood levels of SOD and MDA were measured before blood loss (T1), shock and MAP 40mmHg (T2), 20mmHg (T3) and 30min (T4), 60min (T5) and 120min (T6) , CO, CI, resuscitation 120min when the amount of peritoneal blood loss. Results: The volume of transfusion and intraperitoneal blood loss in group Ⅰ were significantly higher than those in group Ⅱ (P <0.01, P <0.05). After reperfusion, SDO activity of group Ⅰ decreased progressively, blood MDA increased rapidly, significantly higher than group Ⅱ at T5, while there was no significant difference between group Ⅱ and group T3 T6SOD was significantly higher than that of group Ⅰ (P <0.05). Group ⅡMAP was more stable than group Ⅰ during reperfusion. The survival rate of group I at 12 0min was lower than that of group Ⅱ (P <0.05). CONCLUSION: Compared with LR, severe uncontrolled hemorrhagic shock with low pressure resuscitation can significantly reduce lipid peroxidation during reperfusion, maintain stable hemodynamics and reduce animal mortality.