摘要
目的通过正交实验设计，观察6％羟乙基淀粉（6％HES）、复方氯化钠实验研究和生理盐水在低血容量性休克不同阶段的治疗作用及对毛细血管渗漏的影响。方法确立实验因素为液体种类、给液剂量和给液时机，实验水平数为三水平，由此选用L9（3^4）正交表。随机选择27只健康新西兰大白兔，根据正交表顺序建立失血性休克模型，在不同时机输入相应的液体。输液后，由颈内静脉注入伊文思蓝（EB），观察3h后处死，（1）取右肺中叶0．5g组织，计算含水率；（2）用EB标准品测出EB标准曲线，计算出伊文思蓝含量回归方程；（3）取右肺中叶0．1～0．3g组织，碾碎后用甲酰胺萃取EB，离心后用分光光度仪测EB吸光度，根据EB回归方程计算出EB含量；（4）观察肺病理变化。结果肺含水率和EB含量方差分析结果均表明：A（液体种类）、B（给液剂量）和C（给液时机）三个因素均有统计学意义，A为主要因素，其次为B，再次为C。病理结果：A1B3C2组肺损伤最轻，其他由轻到重依次为A1B2C2、A3B3C2、A1B3C3、A3B2C1、A2B2C3、含B1的三组，A2B3C1肺损伤最重。结论选择中分子羟乙基淀粉（200／0．5）20ml／kg于休克代偿期输入，可降低肺毛细血管通透性，减轻肺水肿及肺损伤，对低血容量性休克时肺毛细血管渗漏可能有治疗作用。
Objective According to orthogonal design, the effects of 6% hydroxyethyl starches （HES）200/0.5, Ringer＇s solution or normal saline （NS） on capillary hyperpermeability and therapeutic outcome were studied in rabbits in variant phase of hypovolemic shock. Methods The kind and dosage of fluids and the time of injection were taken as three experiment factors. The orthogonal layout of L9 （34 ）was selected. Twenty-seven New Zealand rabbits weighed 2.5-2.8 kg were selected randomly and the models of the hypovolemic shock were established according to the sequence of orthogonal layout. After infusion of the fluids, 0.5% E＇vans blue （EB） was injected iv. Three hours later, the rabbits were killed. The lungs were removed for pathologic examination under microscope, and for determination of lung water content. EB content in the lungs was determined by formamide extracting method. Results A significant difference was found among the three factors, with an importance order of A（kind of fluid）〉 B（dosage）〉 C（time of usage）. The intuitive data analysis of experiment indicated that AlPaCa was the best fluid therapeutic scheme and its pulmonary pathology injury was the lightest. Condusion In the compensation phase of hypovolemic shock, HES200/0.5 20 ml/kg can decrease capillary permeability, attentuate pulmonary edema and lung injury.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第8期626-628,共3页
Journal of Clinical Anesthesiology
