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不同浓度盐水对失血性休克家兔肾脏功能及组织损伤的研究

Effects of different concentrations of saline on renal function and pathology of experimental animal with uncontrolled hemorrhagic Shock
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摘要 目的模拟机体怡控制性失血性休克过程.以家兔为实验对象,探索不同浓度盐水(4.5%与7.5%)对非控制性失血性休克家兔肾脏功能及病理影响:方法将家兔随机分成5组,若实验过程家兔死亡,补充并保持每组有效家兔数址为8只分别为假手术组(SO组)、休克未治疗组(SNT组)、生理盐水组(NS组).4.5%盐水组(4.5%,组).7.5%盐水组(7.5%,组),建必非控制性失血性休克模型,在设定时间,使用预设方案进行液体复苏,监测不同时间点(0 min .30 inin、60 min .90 min)家兔肾功能指标的变化情况.并在实验最后取心肺肾组织切片做HE染色观察结果SO组肾功指标较平稳,SNT组呈现缓慢匕升趋势,NS组给予液体复苏后各项指标呈现先上升后下降趋势,4.5%组和7.5%组给予液体复苏均后呈现下降的趋势.方差结果分析,各组家兔肾功指标BUN .Cr有显著性差异,11.7.5%组下降速度更快;NS组、4.5%组和7.5%组病理切片损伤明显轻于SNT组。结论高渗盐水对于失血性休克的救治效果要优于生理盐水.且7.5%浓度一定程度上优于4.5%浓度复苏效果,根据实验结果为临床液体复苏提供指导.可进一步研发一体化输注装备,指导与促进群体伤员现场的自救互救。 Objective To investigate the ellrds ofconcentrations of saline on the renal function and pathology of experimental aninuil with uncontrolled hemorrhagic shock. Methods Forty rabbits were randomly divided into 5 equal groups with 8 effective rabbits therein always: sham-operation (SO) group, untreated shock (SNT) group with untrccitrdheinonhagic shockcausrd by opening the femoral arterial calheter, normal saline (NS) group in fused with NS within 10 min and then with ciystal-colloifl mixed fluid to keep the mean arterial pressure (MAP) at 50~55 mmHg 45% sciline (4.5%) group infused with 4.5% saline first and then crystal-colloid mixed fluid, and 7.5% saline (7.5%) group ini used with 7.5% stilitie first and then crystal-colloid mixed fluid. Samples of femoral arterial blood w(*re col levied al the time points 0 min. 30 min. and 60 min respectively to test the levels of the indicators of renal functioniseruin urea nitrogen (BUN) and creatiiiine(Cr). 100 min later the rabbits were killed with their hearts and kidneys taken out to undergo HE staining and pathological examinalion. Results The indicators of renal function in I lie SO group were stable. Ihe BLN ami Cr levels in the acute shock period of the SNT, NS, 4.5%, and 7.5% groups were all significaiilly higher than those at 0 min (all P <0.05). bill without significant differences among these groups (all P >0.05). Both the BUN and Cr levels of llie SNT group showed a rising trend. The BUN and Cr levels after fluid rrsiHcitalion rost1 firsl atid then decrease in the NS group, and both decreased in the 4.5% and 7.5% gloups, however, there was no significant differences between the lasl 2 groups (all P > 0.05). The pathological c hanges in the heart and kidneys were severe in the SNT group and much lighter in the NS. NS, 4.5%, and 7.5% groups, however, there were not signifii anl dinrrrnces among the lasl 3 groups. Conclusion The effects of hypertonic stiline on hemorrhagic shock are better than those of normal saline, and the 7.5 percent concentration is better th
作者 徐蕾 熊凯文 胡文东 康丰娟 刘喜文 XU Lei;XIONG Kai wen;HU Wen dong;KANG Feng juan;LIU Xi wen(Air Force Medical University, Shanxi Xi'an, 710032, China)
出处 《中国急救复苏与灾害医学杂志》 2019年第5期438-441,共4页
基金 部队重点课题:军事人员心理评佔与训练装备研究(12XLZ105).
关键词 失血性休克 液体复苏 高渗盐水 肾功能 病理变化 Hemorrhagic shock Fluid resuscitation Hypertonic saline Renal function
作者简介 通信作者:刘喜文,F2-mail:Liuwen@fmniu.rdu.cn.
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