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热负荷和脱水对高渗盐溶液治疗失血性休克疗效的影响

The effect of heat load and dehydration on hypertonic saline solution treatment of uncontrolled hemorrhagic shock.

作者信息

Krausz M M, Klemm O, Amstislavsky T, Horovitz M

机构信息

Dept. of Surgery B, Carmel Medical Center, Haifa, Israel.

出版信息

J Trauma. 1995 May;38(5):747-52. doi: 10.1097/00005373-199505000-00012.

Abstract

Hypertonic saline solution treatment of uncontrolled hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in arterial blood pressure, and increased mortality. The effect of dehydration induced by either water deprivation or heating on this response was studied in rats. The animals were divided into four groups: group 1 (n = 32), normal rats; group 2 (n = 30), water deprivation for 12 hours; group 3 (n = 30), heating at 37 degrees C for 5 hours; and group 4 (n = 30), heating as in group 3 and water deprivation as in group 2. UCHS was induced in all rats by 20% resection of the animals' tail. The rats were then divided into four treatment subgroups: group a was untreated, group b was treated after 15 minutes with 5 mL/kg NaCl 7.5% hypertonic saline (HTS), group c was treated after 15 minutes with 41.5 mL/kg NaCl 0.9% large volume normal saline (LNS) and group d was treated after 15 minutes with HTS + LNS. Tail resection in group 1a resulted in bleeding of 4.9 +/- 0.3 mL, and fall in mean arterial pressure (MAP) to 50 +/- 3 mm Hg (p < 0.001). Blood loss and fall in hematocrit in groups 2, 3, and 4 was significantly lower than in group 1. The fall in MAP and pulse rate was similar in all four groups.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

高渗盐溶液治疗失血性休克(UCHS)会导致受伤血管出血增加、动脉血压下降以及死亡率上升。本研究在大鼠中探讨了因缺水或加热导致的脱水对这种反应的影响。动物被分为四组:第1组(n = 32),正常大鼠;第2组(n = 30),缺水12小时;第3组(n = 30),在37摄氏度加热5小时;第4组(n = 30),加热方式同第3组,缺水方式同第2组。通过切除大鼠20%的尾巴在所有大鼠中诱导UCHS。然后将大鼠分为四个治疗亚组:a组未治疗,b组在15分钟后用5 mL/kg 7.5%高渗氯化钠(HTS)治疗,c组在15分钟后用41.5 mL/kg 0.9%大量生理盐水(LNS)治疗,d组在15分钟后用HTS + LNS治疗。第1a组尾巴切除后出血4.9 +/- 0.3 mL,平均动脉压(MAP)降至50 +/- 3 mmHg(p < 0.001)。第2、3和4组的失血量和血细胞比容下降显著低于第1组。所有四组的MAP和脉搏率下降相似。(摘要截断于250字)

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