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-  2015 

早期微量泵控制输注去甲肾上腺素对失血性休克兔血流动力学和心肌功能的影响 Efficacy of Early Micro-pump Norepinephrine Infusion on Hemodynamics and Myocardial Functions of Hemorrhagic Shock Rabbit

Keywords: 失血性休克,去甲肾上腺素,血流动力学,心肌功能,微量泵

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Abstract:

目的:探讨失血性休克早期微量泵控制输注去甲肾上腺素,对家兔血流动力学、心肌和心功能的影响。方法:实验采用健康成年新西兰兔,随机分为失血性休克去甲肾上腺素治疗组(NE组,n=7)和失血性休克生理盐水治疗组(NS组,n=7);股动脉放血法制备失血性休克模型成功后,NE组立即给予10min去甲肾上腺素的微量泵泵入,速度为0.2-1mg/(kg·h),同时静脉输注与丢失血量等量的生理盐水;NS组立即给予10min生理盐水补液治疗,补液量为3倍的丢失血量,同样采取微量泵匀速补液。10min强化治疗结束,记录为0h。随后维持并记录0,0.5,1,2,4h各时间点血流动力学指标,并留取血清进行心肌酶学(CK和CKMB)和肌钙蛋白(cTnI)分析。结果:NE组较NS组心率明显提高;NS仅在治疗前期(0h和1h)改善平均动脉压(MAP),NE则可在各时间点持续有效改善MAP;NE在一定的使用时程内(0-2h)可改善失血性休克动物的左室平均压(LVAP);NE较NS可明显提升失血性休克的左心室收缩功能;NE较NS从0.5h起可明显改善左心室舒张功能;心肌酶学和TnI结果显示NE组与NS组整体存在明显差异:CK[(23.87±16.85)vs.(13.22±2.50)ng/ml,P<0.05],CKMB[(8.80±5.68)vs.(5.27±1.14)ng/ml,P<0.05]和cTnI[(109.09±37.81)vs.(84.87±10.73)pg/ml,P<0.05]。结论:早期微量泵控制给予去甲肾上腺素治疗失血性休克,有助于改善早期血流动力学和心功能指标,但可能增加失血性休克心肌的损伤

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