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目的观察精氨酸血管加压素(arginine vasopressin,AVP)对非控制性出血性休克大鼠彻底止血后复苏效果。方法采用大鼠脾实质切除及脾动脉切断方法复制非控制性出血性休克模型,在止血前采用低压复苏(50mmHg,1h)后结扎血管彻底止血,观察乳酸林格氏液(Lactated Ringer’s,LR)、AVP(0.4U/kg和0.04U/kg)对大鼠血流动力学指标、血气指标、存活时间和存活率的影响。LR组在彻底止血后输注2倍失血量LR;AVP0.1U/kg组和0.4U/kg组在2倍量的LR中分别加入AVP0.4U/kg和0.04U/kg输注。结果非控制性出血性休克大鼠在休克后以及低压复苏后血流动力学指标包括左心室收缩压(left intraventricular systolic pressure,LVSP)、左心室压力上升或下降的最大速率(themaximal change rate of left intraventricular pressure,±dp/dtmax)明显低于休克前(P<0.05),血气也发生了明显改变;2倍失血量的LR输注不能较好地恢复平均动脉血压(mean artery pressure,MAP)和血流动力学指标,AVP0.4U/kg和0.04U/kg输注,明显增加MAP和改善休克大鼠血流动力学指标,延长休克动物存活时间并提高存活率,与LR组相比明显升高(P<0.05)。结论AVP对非控制性出血性休克大鼠彻底止血后有较好的复苏效果。
Objective To observe the effect of arginine vasopressin (AVP) on complete hemostasis after non-controlled hemorrhagic shock in rats. Methods Uncontrolled hemorrhagic shock model was reproduced by splenectomy and splenic artery occlusion in rats. Lactated Ringer’s (LR) was used to stop the hemostasis after low pressure resuscitation (50mmHg, 1h) , AVP (0.4U / kg and 0.04U / kg) on hemodynamics, blood gas index, survival time and survival rate in rats. The LR group was transfused with 2X blood loss after complete hemostasis. AVP0.1U / kg group and 0.4U / kg group were given AVP0.4U / kg and 0.04U / kg respectively in 2 times of LR. Results The hemodynamic parameters of non-control hemorrhagic shock rats after shock and low pressure resuscitation included left intraventricular systolic pressure (LVSP), themaximal change rate of left (left ventricular pressure) intraventricular pressure, ± dp / dtmax) were significantly lower than those before shock (P <0.05), blood gas also changed significantly; 2-times blood loss LR infusion did not recover mean arterial pressure (MAP) The indexes of hemodynamics, AVP0.4U / kg and 0.04U / kg infusion significantly increased MAP and improved hemodynamics in shock rats, prolonging the survival time of shock animals and increasing the survival rate compared with LR group High (P <0.05). Conclusions AVP has a good resuscitation effect after hemostasis in non-controlled hemorrhagic shock rats.