CAJ | 학술논문

目的探讨小容量复苏对失血性休克犬早期血流动力学及内脏组织灌注的影响.方法分别给予6 ml/kg高渗盐水(HS组)和6 ml/kg高渗盐水加羟乙基淀粉溶液(HSS组)对失血性休克犬进行容量复苏,并以失血量3倍的等渗盐水(NS组)作对照,观察复苏后早期血流动力学及胃肠黏膜组织灌注指标小肠黏膜pH值(pHi)的变化. 结果 (1)3种溶液均能改善失血性休克犬复苏的早期血流动力学及组织灌注,但在30 min后高渗盐水、HSS及等渗盐水容量指标下降,血流动力学下降,其中高渗盐水及等渗盐水下降最为明显.(2)随着血流动力学下降,3组pHi于120 min后开始下降,而动脉乳酸无升高. 结论 (1)小容量高渗盐水在失血性休克模型中的复苏效果与等渗盐水类似,小容量高渗盐水加羟乙基淀粉溶液的效果优于前两组.(2)pHi是监测组织灌注的良好指标,比动脉乳酸更为敏感.
목적 탐토소용량복소대실혈성휴극견조기혈류동역학급내장조직관주적영향.방법분별급여6 ml/kg고삼염수(HS조)화6 ml/kg고삼염수가간을기정분용액(HSS조)대실혈성휴극견진행용량복소,병이실혈량3배적등삼염수(NS조)작대조,관찰복소후조기혈류동역학급위장점막조직관주지표소장점막pH치(pHi)적변화. 결과 (1)3충용액균능개선실혈성휴극견복소적조기혈류동역학급조직관주,단재30 min후고삼염수、HSS급등삼염수용량지표하강,혈류동역학하강,기중고삼염수급등삼염수하강최위명현.(2)수착혈류동역학하강,3조pHi우120 min후개시하강,이동맥유산무승고. 결론 (1)소용량고삼염수재실혈성휴극모형중적복소효과여등삼염수유사,소용량고삼염수가간을기정분용액적효과우우전량조.(2)pHi시감측조직관주적량호지표,비동맥유산경위민감.
Objective To investigate the effects of small volume resuscitation on hemodynamics and visceral perfusion in dog model of hemorrhagic shock. Methods Twenty-four dogs were hemorrhaged to hold mean arterial blood pressure at 45-55 nun Hg for 45 minutes, and then eight dogs were resuscitated with 6 ml/kg of hypertonic saline (HS group) solution and the other eight resuscitated with 6 ml/kg of hypertonic saline-hydroxyethyl starch (HSS group) solution. The rest eight dogs were set as control and resuscitated with normal saline (NS). Hemodynamics and gastrointestinal intramucosal pH (pHi) were detected after fluid resuscitation. Results (1) All three kinds of solutions could improve early hemodynamics and visceral perfusion. But 30 minutes after fluid resuscitation, the hemodynamics of dogs in HS group, HSS group and NS group began to decrease, with more obvious decrease HS group and NS group compared with HSS group. (2) pHi of three groups began to decrease 120 minutes after fluid resuscitation, but the level of arterial lactate remained unchanged. Conclusions (1) HS has the similar effect as NS in aspect of resuscitation, and HSS is better than HS and NS.(2) pHi is an ideal marker in monitoring the visceral perfusion and has higher sensitivity than arterial lactate.