Xie Fei, Hou Ke-dong, Song Qing, Jiang Chao-guang
Department of Surgical Intensive Care Unit, General Hospital of PLA, Beijing 100853, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010 May;22(5):309-12.
To observe the change in bone marrow after intraosseous hypertonic saline- hydroxyethyl starch (HSH) in dogs with hemorrhagic shock.
Eighteen male dogs were randomly divided into sham group, normal saline (NS) group (0.9% sodium chloride) and HSH group (7.5% sodium chloride-6% hydroxyethyl starch). Wiggers graded controlled hemorrhagic shock model was reproduced in NS and HSH groups, and above solutions were injected into bone marrow of the tibia in low dosage (4 ml/kg) rapidly (within 5 minutes). The sham group did not lose blood or receive infusion. CD34(+) expression of peripheral blood and bone marrow, and the change in picture of different hematopoietic series in bone marrow were examined before and after bone marrow resuscitation. Pathological change in bone marrow was examined after different resuscitation fluid infusion.
After 48 hours of resuscitation, the percentage of CD34(+) in bone marrow and peripheral blood in HSH group were significantly higher than that of NS group [peripheral blood: (6.915+/-1.178)% vs. (4.848+/-0.527)%, bone marrow: (7.900+/-0.648)% vs. (6.875+/- 0.403)% , both P<0.05]. One week after resuscitation, the erythrocyte count and granulocytic count in NS group were significantly increased compared with sham group (erythrocyte count: 0.289+/-0.016 vs. 0.253+/-0.014, granulocytic count: 0.615+/-0.019 vs. 0.560+/-0.013, both P<0.05], lymphocytic count was significantly decreased (0.049+/-0.007 vs. 0.132+/-0.015, P<0.05). In the HSH group, erythrocyte count (0.273+/-0.012), lymphocytic count (0.162+/-0.014) were all significantly increased (both P<0.05), while granulocytic count (0.517+/-0.038) was significantly decreased (P<0.05). After 4 week of resuscitation, the change in hemopoiesis series in NS group and HSH group recovered to normal level. The bone marrow morphology changed slightly, and no bone necrosis occurred.
HSH in small amount through intraosseous space is safe and effective as a fluid resuscitation measure for shock, and little change in bone marrow has been found after the infusion.
观察失血性休克犬经骨髓腔内输注高渗盐水-羟乙基淀粉（HSH）后骨髓的变化。
18只雄性犬随机分为假手术组、生理盐水（NS）组（0.9%氯化钠）和HSH组（7.5%氯化钠-6%羟乙基淀粉）。NS组和HSH组复制Wiggers分级控制性失血性休克模型，将上述溶液以低剂量（4 ml/kg）快速（5分钟内）注入胫骨骨髓。假手术组不失血也不输液。在骨髓复苏前后检测外周血和骨髓中CD34(+)表达以及骨髓中不同造血系列的图像变化。输注不同复苏液后检查骨髓病理变化。
复苏48小时后，HSH组骨髓和外周血中CD34(+)百分比显著高于NS组[外周血：(6.915±1.178)%对(4.848±0.527)%，骨髓：(7.900±0.648)%对(6.875±0.403)%，均P<0.05]。复苏1周后，NS组红细胞计数和粒细胞计数与假手术组相比显著增加（红细胞计数：0.289±0.016对0.253±0.014，粒细胞计数：0.615±0.019对0.560±0.013，均P<0.05），淋巴细胞计数显著减少（0.049±0.007对0.1
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