Krausz Michael M, Semenikhina Liubov, Hirsh Mark
Department of Surgery A and the Laboratory for Shock and Trauma Research, Rambam Medical Center, 31096 Haifa, Israel.
J Surg Res. 2006 May;132(1):23-31. doi: 10.1016/j.jss.2005.08.029. Epub 2005 Oct 26.
In the present investigation the effect of fluid treatment in uncontrolled hemorrhagic shock after massive splenic injury (MSI) was comparatively studied in male and female rats.
The anesthetized animals were randomly divided into three groups: in group 1 MSI was induced in males, in group 2 MSI was induced in females in proestrus, in group 3 MSI was induced in females in metestrus. Each group was divided into four subgroups: a) Sham-operated, b) MSI untreated (UT), c) MSI treated with 40 ml/kg lactated Ringer's solution (RL), and d) MSI treated with 5 ml/kg NaCl 7.5% (HTS).
Total blood loss (TBL) in groups 1b, 2b, and 3b was 31.7 +/- 3.6%, 33.1 +/- 2.6%, and 36.7 +/- 2.6%, respectively, and mean survival time (MST) was 143.7 +/- 25.3 min, 174.8 +/- 10.4 min, and 67.8 +/- 11.4 min (P < 0.01 versus group 2b), respectively. TBL in groups 1c, 2c, and 3c increased to 52.4 +/- 5.5% (P < 0.02 versus UT), 48.6 +/- 1.6% (P < 0.02 versus UT), and 48.8 +/- 4.1% (P < 0.02 versus UT), respectively, and MST decreased to 126 +/- 19.4 min, (P < 0.05 versus UT), and 136.8 +/- 13.0 min (P < 0.05 versus UT) in groups 1c and 2c, respectively, and increased in group 3c to 120.4 +/- 23.3 min (P < 0.05 versus UT). TBL in groups 1d, 2d, and 3d was 31.3 +/- 4.8%, 38.0 +/- 4.2%, and 40.6 +/- 3.7%, respectively, and MST increased to 198.5 +/- 13.9 min (P < 0.05 versus UT) in group 1d, decreased to 128.4 +/- 17.2 min (P < 0.01) in group 2d, and increased to 102.6 +/- 19.0 min (P < 0.002 versus group 1d) in group 3d.
RL infusion significantly increased blood loss in all three groups, reduced survival time in males and female rats in proestrus, but significantly improved survival in females in metestrus. HTS treatment did not alter blood loss in all three groups, but significantly improved survival in females in metestrus and males.
在本研究中，对雄性和雌性大鼠大规模脾损伤（MSI）后非控制性出血性休克的液体治疗效果进行了比较研究。
将麻醉后的动物随机分为三组：第1组对雄性大鼠诱导MSI，第2组对处于发情前期的雌性大鼠诱导MSI，第3组对处于动情后期的雌性大鼠诱导MSI。每组再分为四个亚组：a）假手术组，b）未治疗的MSI组（UT），c）用40 ml/kg乳酸林格氏液（RL）治疗的MSI组，d）用5 ml/kg 7.5%氯化钠（HTS）治疗的MSI组。
第1b、2b和3b组的总失血量（TBL）分别为31.7±3.6%、33.1±2.6%和36.7±2.6%，平均生存时间（MST）分别为143.7±25.3分钟、174.8±10.4分钟和67.8±11.4分钟（与第2b组相比，P<0.01）。第1c、2c和3c组的TBL分别增加至52.4±5.5%（与UT组相比，P<0.02）、48.6±1.6%（与UT组相比，P<0.02）和48.8±4.1%（与UT组相比，P<0.02），第1c和2c组的MST分别降至126±19.4分钟（与UT组相比，P<0.05）和136.8±13.0分钟（与UT组相比，P<0.05），第3c组增加至120.4±23.3分钟（与UT组相比，P<0.05）。第1d、2d和3d组的TBL分别为31.3±4.8%、38.0±4.2%和40.6±3.7%，第1d组的MST增加至198.5±13.9分钟（与UT组相比，P<0.05），第2d组降至128.4±17.2分钟（P<0.01），第3d组增加至102.6±19.0分钟（与第1d组相比，P<0.002）。
RL输注在所有三组中均显著增加失血量，缩短雄性和发情前期雌性大鼠的生存时间，但显著提高动情后期雌性大鼠的生存率。HTS治疗在所有三组中均未改变失血量，但显著提高动情后期雌性大鼠和雄性大鼠的生存率。
