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出血性休克期间液体输注对血清蛋白浓度的影响。

The effect of fluid infusions upon serum protein concentrations during hemorrhagic shock.

作者信息

Getzen L C, Pollak E W, Clifford A J, Wolfman E F

出版信息

Surg Gynecol Obstet. 1978 May;146(5):745-9.

PMID:644433
Abstract

Of 24 dogs subjected to hemorrhagic shock, 12 resuscitated with intravenous infusions containing 2.5 per cent human serum albumin maintained significantly higher, p less than 0.05, serum albumin levels than did 12 others treated with Ringer's lactate solution, with or without 50 per cent dog plasma. These differences persisted for as long as six weeks after hemorrhage. Dogs resuscitated with Ringer's lactate solution and 50 per cent dog plasma had significantly higher serum globulin levels than did the dogs receiving 2.5 per cent albumin containing infusion during the first three days after hemorrhage. The simultaneous addition of 5 per cent glucose, potassium chloride and hydrocortisone sodium succinate to the infusion of dogs receiving 2.5 per cent albumin in Ringer's lactate solution did not provide significant alterations in the serum concentration of protein and protein fractions when compared with those of dogs receiving only 2.5 per cent albumin in Ringer's lactate solution. These findings corroborate the suggestion of a capillary leak of serum albumin into the interstitial space during hemorrhagic shock that persists for at least one week after hemorrhage. The administration of albumin containing solutions during the initial stages of hemorrhagic shock counteracts this albumin loss.

摘要

在24只遭受失血性休克的狗中,12只用含2.5%人血清白蛋白的静脉输注液复苏的狗,其血清白蛋白水平显著高于另外12只用乳酸林格氏液治疗的狗(无论是否添加50%犬血浆),p值小于0.05。这些差异在出血后长达六周的时间里持续存在。用乳酸林格氏液和50%犬血浆复苏的狗在出血后的头三天里血清球蛋白水平显著高于接受含2.5%白蛋白输注液的狗。与仅接受含2.5%白蛋白的乳酸林格氏液输注的狗相比,在接受含2.5%白蛋白的乳酸林格氏液输注的狗的输注液中同时添加5%葡萄糖、氯化钾和氢化可的松琥珀酸钠,并未使血清蛋白和蛋白组分浓度发生显著改变。这些发现证实了失血性休克期间血清白蛋白向间质间隙毛细血管渗漏的观点,这种渗漏在出血后至少持续一周。在失血性休克初始阶段给予含白蛋白溶液可抵消这种白蛋白丢失。

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