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目的比较乳酸林格液(LR)和6%羟乙基淀粉200/0.5(HES 200/0.5)对脓毒症犬进行液体复苏时对氧代谢和毛细血管通透性的影响,为液体选择提供依据。方法30只犬随机分为3组(n=10):对照组行假手术后用乳酸林格液作为输注液体,LR组造脓毒症模型后用乳酸林格液作为复苏液体,HS组造脓毒症模型后用羟乙基淀粉200/0.5作为复苏液体。在脓毒症前、脓毒症后1、4、8 h测白蛋白逃离率(AER)、氧耗(VO2)、氧供(DO2)、混合静脉氧饱和度(SvO2)、心排血量(CO)、心脏指数(CI)、血浆容量(PV)、动脉血压(MAP)、中心静脉压(CVP)和肺毛细血管楔压(PCWP)等。结果LR、HS组MAP、CO、DO2、SvO2在脓毒症发生后4、8 h较同组基础值及对照组均有明显下降,但HS组较LR组高(P<0.05);LR组的VO2在脓毒症发生后8 h较基础值明显下降(P<0.05),而对照组和HS组VO2无明显变化;在脓毒症发生后4、8 h,对照组血浆容量(PV)明显升高,LR组明显降低(P<0.05),而HS组无明显变化;在脓毒症发生后4、8 h,LR、HS组AER较基础值及对照组明显升高(P<0.05),而LR和HS组间无明显差异。结论脓毒症后毛细血管通透性增加,乳酸林格液、6%HES对犬脓毒症后毛细血管通透性的影响没有明显差异,但6%HES更有利于血浆容量的维持和氧合的改善。
Objective To compare the effects of lactic acid Ringer’s (LR) and 6% hydroxyethyl starch 200 / 0.5 (HES 200 / 0.5) on oxygen metabolism and capillary permeability in liquid resuscitation in septic dogs, in accordance with. Methods Thirty dogs were randomly divided into three groups (n = 10): control group were given lactic acid Ringer’s solution as infusion liquid after sham operation, LR group was treated with lactic acid Ringer’s solution as resuscitation liquid after sepsis model, HS group After the sepsis model was made with hydroxyethyl starch 200 / 0.5 as the resuscitation fluid. Before sepsis, albumin escape rate (AER), oxygen consumption (VO2), oxygen supply (DO2), mixed venous oxygen saturation (SvO2), cardiac output (CO), cardiac index (CI), plasma volume (PV), arterial pressure (MAP), central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) Results The MAP, CO, DO2 and SvO2 in LR group were significantly lower than those in the same group and the control group 4 and 8 h after sepsis in HS group (P <0.05), while the LR group VO2 decreased significantly at 8 h after sepsis (P <0.05), but there was no significant change in VO2 in control group and HS group. At 4 and 8 h after sepsis, the plasma volume (PV) (P <0.05), but there was no significant change in HS group. At 4 and 8 h after sepsis, the AER in LR and HS groups was significantly higher than the baseline and control group (P <0.05) ), While there was no significant difference between LR and HS groups. Conclusions Capillary permeability increased after sepsis. There was no significant difference in capillary permeability between lactated Ringer ’s solution and 6% HES after sepsis, but 6% HES was more conducive to the maintenance of plasma volume and oxygen Improve together.