本文主要研究内容
作者何静维娜（2019）在《高分子替血白蛋白对犬失血性休克的疗效观察》一文中研究指出：目的:探索高分子替血白蛋白溶液(Hydroxyethyl starch 130/0.4 and sodium chloride injection,HES)对犬失血性休克的治疗效果,为临床应用高分子替血白蛋白治疗犬失血性休克提供试验参考。方法:选择贵阳地区的本地狗12只,体重6.10±1.14 kg,将其随机分2组,高分子替血白蛋白溶液治疗组(HES组)、0.9%氯化钠注射液治疗组(0.9%sodium chloride injection,SC组),每组6只。犬眠宝(0.15 ml/kg)全身麻醉,手术前用彩色B超确定颈动脉位置,手术分离出颈动脉,用消毒好的Y型留置针做血管插管,缝合线固定留置针于颈动脉上,肝素钠抗凝,缝合肌肉和皮肤,最后用弹力绷带将留置针固定在颈部,供放血用。术后24h,在非麻醉状态下,30 min内从颈动脉快速放血,使失血量达犬全身血量的40%-50%,MAP维持在45±5mm Hg 1 h,制成失血性休克模型。HES组先静脉滴注高分子替血白蛋白溶液(20 mL/kg),再按40 mL/kg静注生理盐水;SC组按60mL/kg静脉滴注0.9%氯化钠注射液。检测两种治疗方法用药前后血常规指标特别是红细胞相关参数、生化指标、电解质变化,连续检测用药中及用药后1 h血压的变化,结合临床症状及病犬的康复情况,判断两种治疗方法的临床治疗效果。结果:试验结果如下:1.颈动脉插管:术后24小时,颈动脉插管成功率为75%,可用于失血性休克模型的制作。2.成功建立失血性休克模型:MAP维持在45±5 mm Hg时,犬可视黏膜苍白,皮肤湿冷,脉搏频弱,呼吸困难,尿量减少,烦躁不安或神情淡漠,大便失禁。3.用药时血压变化:静脉滴注高分子替血白蛋白15分钟时MAP开始显著上升,输液结束时MAP上升至61.33±6.71 mm Hg;静脉注射生理盐水时,MAP升高不显著,只有DP在输液结束时显著升高;与SC组比较,HES组MAP升高较快,差异显著或极显著。4.用药后血压的变化:高分子替血白蛋白用药后60 min,MAP、SP、DP分别为75.17±3.60mm Hg、100.33±2.31mm Hg和67.00±3.61mm Hg,而生理盐水组MAP、SP、DP则分别为58.67±0.58 mm Hg、78.50±0.71mm Hg、52.00±0.00 mm Hg,两者相比,差异极显著。5.各时段血常规变化:HCT在休克时为,静脉滴注高分子替血白蛋白后1 h后为上升到34.00±3.25%,接近正常值,与生理盐水组相比,差异极显著;同时,RBC也显著上升,与生理盐水组相比,差异显著。PLT在用药1 h后有所上升,显著上升;WBC极显著上升。6.用药后临床表现:高分子替血白蛋白用药后1 h,可视黏膜粉红,治疗后第2 d精神状态较好,未继续治疗而康复。生理盐水组用药后可视黏膜仍苍白,四肢冰凉,呼吸急促,呕吐,嗜睡,治疗后第2 d精神状态较差,不吃,仍需要继续治疗。7.生化及电解质变化:生化及电解质无异常。结论:高分子替血白蛋白溶液能持续上升休克犬的平均动脉压、收缩压、舒张压,快速恢复休克犬的红细胞压积,改善缺血状态,扩容效果稳定,对犬失血性休克有很好的疗效。
Abstract
mu de :tan suo gao fen zi ti xie bai dan bai rong ye (Hydroxyethyl starch 130/0.4 and sodium chloride injection,HES)dui quan shi xie xing xiu ke de zhi liao xiao guo ,wei lin chuang ying yong gao fen zi ti xie bai dan bai zhi liao quan shi xie xing xiu ke di gong shi yan can kao 。fang fa :shua ze gui yang de ou de ben de gou 12zhi ,ti chong 6.10±1.14 kg,jiang ji sui ji fen 2zu ,gao fen zi ti xie bai dan bai rong ye zhi liao zu (HESzu )、0.9%lv hua na zhu she ye zhi liao zu (0.9%sodium chloride injection,SCzu ),mei zu 6zhi 。quan mian bao (0.15 ml/kg)quan shen ma zui ,shou shu qian yong cai se Bchao que ding geng dong mai wei zhi ,shou shu fen li chu geng dong mai ,yong xiao du hao de Yxing liu zhi zhen zuo xie guan cha guan ,feng ge xian gu ding liu zhi zhen yu geng dong mai shang ,gan su na kang ning ,feng ge ji rou he pi fu ,zui hou yong dan li beng dai jiang liu zhi zhen gu ding zai geng bu ,gong fang xie yong 。shu hou 24h,zai fei ma zui zhuang tai xia ,30 minnei cong geng dong mai kuai su fang xie ,shi shi xie liang da quan quan shen xie liang de 40%-50%,MAPwei chi zai 45±5mm Hg 1 h,zhi cheng shi xie xing xiu ke mo xing 。HESzu xian jing mai di zhu gao fen zi ti xie bai dan bai rong ye (20 mL/kg),zai an 40 mL/kgjing zhu sheng li yan shui ;SCzu an 60mL/kgjing mai di zhu 0.9%lv hua na zhu she ye 。jian ce liang chong zhi liao fang fa yong yao qian hou xie chang gui zhi biao te bie shi gong xi bao xiang guan can shu 、sheng hua zhi biao 、dian jie zhi bian hua ,lian xu jian ce yong yao zhong ji yong yao hou 1 hxie ya de bian hua ,jie ge lin chuang zheng zhuang ji bing quan de kang fu qing kuang ,pan duan liang chong zhi liao fang fa de lin chuang zhi liao xiao guo 。jie guo :shi yan jie guo ru xia :1.geng dong mai cha guan :shu hou 24xiao shi ,geng dong mai cha guan cheng gong lv wei 75%,ke yong yu shi xie xing xiu ke mo xing de zhi zuo 。2.cheng gong jian li shi xie xing xiu ke mo xing :MAPwei chi zai 45±5 mm Hgshi ,quan ke shi nian mo cang bai ,pi fu shi leng ,mai bo pin ruo ,hu xi kun nan ,niao liang jian shao ,fan zao bu an huo shen qing dan mo ,da bian shi jin 。3.yong yao shi xie ya bian hua :jing mai di zhu gao fen zi ti xie bai dan bai 15fen zhong shi MAPkai shi xian zhe shang sheng ,shu ye jie shu shi MAPshang sheng zhi 61.33±6.71 mm Hg;jing mai zhu she sheng li yan shui shi ,MAPsheng gao bu xian zhe ,zhi you DPzai shu ye jie shu shi xian zhe sheng gao ;yu SCzu bi jiao ,HESzu MAPsheng gao jiao kuai ,cha yi xian zhe huo ji xian zhe 。4.yong yao hou xie ya de bian hua :gao fen zi ti xie bai dan bai yong yao hou 60 min,MAP、SP、DPfen bie wei 75.17±3.60mm Hg、100.33±2.31mm Hghe 67.00±3.61mm Hg,er sheng li yan shui zu MAP、SP、DPze fen bie wei 58.67±0.58 mm Hg、78.50±0.71mm Hg、52.00±0.00 mm Hg,liang zhe xiang bi ,cha yi ji xian zhe 。5.ge shi duan xie chang gui bian hua :HCTzai xiu ke shi wei ,jing mai di zhu gao fen zi ti xie bai dan bai hou 1 hhou wei shang sheng dao 34.00±3.25%,jie jin zheng chang zhi ,yu sheng li yan shui zu xiang bi ,cha yi ji xian zhe ;tong shi ,RBCye xian zhe shang sheng ,yu sheng li yan shui zu xiang bi ,cha yi xian zhe 。PLTzai yong yao 1 hhou you suo shang sheng ,xian zhe shang sheng ;WBCji xian zhe shang sheng 。6.yong yao hou lin chuang biao xian :gao fen zi ti xie bai dan bai yong yao hou 1 h,ke shi nian mo fen gong ,zhi liao hou di 2 djing shen zhuang tai jiao hao ,wei ji xu zhi liao er kang fu 。sheng li yan shui zu yong yao hou ke shi nian mo reng cang bai ,si zhi bing liang ,hu xi ji cu ,ou tu ,shi shui ,zhi liao hou di 2 djing shen zhuang tai jiao cha ,bu chi ,reng xu yao ji xu zhi liao 。7.sheng hua ji dian jie zhi bian hua :sheng hua ji dian jie zhi mo yi chang 。jie lun :gao fen zi ti xie bai dan bai rong ye neng chi xu shang sheng xiu ke quan de ping jun dong mai ya 、shou su ya 、shu zhang ya ,kuai su hui fu xiu ke quan de gong xi bao ya ji ,gai shan que xie zhuang tai ,kuo rong xiao guo wen ding ,dui quan shi xie xing xiu ke you hen hao de liao xiao 。
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论文详细介绍
论文作者分别是来自贵州大学的何静维娜，发表于刊物贵州大学2019-07-16论文，是一篇关于高分子替血白蛋白论文,失血性休克论文,治疗论文,贵州大学2019-07-16论文的文章。本文可供学术参考使用，各位学者可以免费参考阅读下载，文章观点不代表本站观点，资料来自贵州大学2019-07-16论文网站，若本站收录的文献无意侵犯了您的著作版权，请联系我们删除。
标签：高分子替血白蛋白论文; 失血性休克论文; 治疗论文; 贵州大学2019-07-16论文;