CAJ | 학술논문

目的观察高渗氯化钠羟乙基淀粉40注射液(HSH)在犬急性颅内高压伴失血性休克模型中恢复循环血容量、减轻脑组织水肿和降低脑组织氧自由基含量的作用.方法健康杂种犬20只,采用硬膜外球囊注水和动脉放血的方法复制急性颅内高压伴失血性休克模型.动物随机分为羟乙基淀粉溶液组(HES组),乳酸盐林格液组(RL组),7.5%氯化钠溶液组(HS组)和高渗氯化钠羟乙基淀粉40注射液组(HSH组),在休克后1 h分别输入相应液体.监测平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)、颅内压(ICP),检测脑组织丙二醛(MDA)含量、超氧化物歧化酶(SOD)活力,脑组织标本行病理学检查.结果复苏后4组液体均能有效地升高MAP(P<0.05),但HES组和RL组的ICP上升明显(P<0.05),复苏后2 h,HS组的MAP开始下降(P<0.05).至复苏后4 h,仅HSH组能维持理想的MAP及较低的ICP,HSH组脑组织氧自由基含量较其他组明显减少(P<0.05).病理学检查显示复苏后4 h,HSH组的脑组织损伤较其他组轻.结论高渗氯化钠羟乙基淀粉40注射液可有效地复苏失血性休克,降低ICP及氧自由基的生成,减轻脑组织缺血/再灌注的损伤.
목적 관찰고삼록화납간을기정분40주사액(HSH)재견급성로내고압반실혈성휴극모형중회복순배혈용량、감경뇌조직수종화강저뇌조직양자유기함량적작용.방법 건강잡충견20지,채용경막외구낭주수화동맥방혈적방법복제급성로내고압반실혈성휴극모형.동물수궤분위간을기정분용액조(HES조),유산염림격액조(RL조),7.5%록화납용액조(HS조)화고삼록화납간을기정분40주사액조(HSH조),재휴극후1 h분별수입상응액체.감측평균동맥압(MAP)、중심정맥압(CVP)、심솔(HR)、로내압(ICP),검측뇌조직병이철(MDA)함량、초양화물기화매(SOD)활력,뇌조직표본행병이학검사.결과 복소후4조액체균능유효지승고MAP(P<0.05),단HES조화RL조적ICP상승명현(P<0.05),복소후2 h,HS조적MAP개시하강(P<0.05).지복소후4 h,부HSH조능유지이상적MAP급교저적ICP,HSH조뇌조직양자유기함량교기타조명현감소(P<0.05).병이학검사현시복소후4 h,HSH조적뇌조직손상교기타조경.결론 고삼록화납간을기정분40주사액가유효지복소실혈성휴극,강저ICP급양자유기적생성,감경뇌조직결혈/재관주적손상.
Objective To observe the effects of hypertonic sodium chloride hydroxyethyl starch 40 injection(HSH) on recovering of circulating blood volume, lessening edema of brain tissue and decreasing oxygen free radicals in dog with acute intracranial hypertension and hemorrhagic shock. Methods 20 healthy dogs were randomly divided into 4 groups: Group hydroxyethyl starch (HES), Group Ringer- lactate solution (RL), Group hypertonic saline solution (HS) and Group HSH. Acute intracranial hypertension and hemorrhagic shock were made by injecting water into epidural balloon and bleeding artery. Corresponding injections were infused respectively 1h after shock. Mean arterial blood pressure (MAP), central venous pressure (CVP), heart rate (HR) and intracranial pressure (ICP) were monitored, and the level of superoxide dismutase (SOD) and malondialdehyde (MDA) in brain tissue were examined. Specimens of brain tissue were prepared for pathological examination. Results After resuscitation, injections of 4 groups can effectively increase MAP( P < 0.05 )while ICP of Group HES and Group RL significantly increased (P < 0.05 ). Two hours after resuscitation, MAP of Group HS began to decrease (P < 0.05 ). Four hours after resuscitation, only Group HSH can maintain an higher MAP and lower ICP. MDA and SOD levels in Group HSH were evidently lower than other groups at four hours after resuscitation (P < 0. 05). Pathological examination revealed less injury in Group HSH than other groups. Conclusion HSH could effectively resuscitate hemorrhagic shock, decrease ICP, reduce oxygen free radicals levels in brain tissue and relieve tissue ischemia/reperfusion injury.