【摘要】 目的　在西藏拉萨高原现场实验 ,观察小剂量 7 5 %NaCl和 6 0 %右旋糖酐 4 0复方溶液 (HSD)对高原失血性休克合并肺水肿大鼠的治疗作用。方法　第一部分新进高原SD大鼠 35只 ,均分 5组 :正常对照组 (n =7) ;单纯休克组 (n =7) ;休克 +肺水肿组 (n =7) ;复方高渗氯化钠—右旋糖酐组 (HSD) (n =7) ;平衡盐液组 (n =7)。维持血压 5 0mmHg ,加股静脉插管给油酸 (5 μL/10 0g体重 ) ,维持 6 0min完成模型 (正常对照组不放血不给油酸 )。分别观察给药后不同时相点的平均动脉压(MAP)、心率 (HR)、呼吸 (RR)、左室收缩压 (LVSP)、左心室压力最大上升和下降速率 (±dp/dtmax)以及动脉血气。实验结束取肺、脑测肺脑含水量 (用湿 /干重比表示 )。第二部分实验新进高原SD大鼠 36只 ,观察HSD对失血性休克合并肺水肿大鼠存活时间的影响。结果　HSD可显著升高高原失血性休克合并肺水肿大鼠平均动脉压 (MAP) ,改善其左室收缩压 (LVSP)、左心室压力最大上升和下降速率 (±dp/dtmax)及动脉血气指标 ,动物存活时间延长 ,肺脑湿 /干重比降低 ,而等容量平衡盐液无明显疗效。结论　HSD对高原创伤失血性休克合并肺水肿有较好的早期治疗作用。更多还原

【Abstract】 Objective To study the effects of hypertonic saline/dextran 40 (7.5% NaCl/6% dextran 40, HSD) on the rats hemo- rrhagic shock with pulmonary edema at high altitude.Methods 71 SD rats,transported to LaSa,Tibet,3 760 meters above the sea level,were anesthetized one week later with sodium pentobarbital (30 mg/kg,ip).Hemorrhagic shock model with pulmonary edema was induced by hemorrhage(50 mmHg) plus intravenous injection of oleic acid (5 μL/100 g wt)for 1 hour.Experiment was conducted in two parts.In part I,35 rats were equally divided into 5 groups (n=7 each group):normal control,hemorrhagic shock,hemorrhagic shock with pulmonary edema (HSPE),HSPE plus lactated Ringer’s solution (LR,4 mL/kg) or HSD (4 mL/kg).Hemodynamic parameters including mean arterial pressure (MAP),left ventricular systolic pressure (LVSP) and the maximum change rate of intraventricular pressure rise or decline (±dp/dt max)were observed at 15,30,60 and 120 min,blood gases were observed at 30 and 120 min,and the water content of lung and brain was determined at 120 min after drug administration.36 rats in part Ⅱ were used to observe the effect of HSD on survival time of hemorrhagic shock with pulmonary edema.Results HSD (4 mL/kg)significantly increased MAP,LVSP and ±dp/dt max ( P <0.05～0.01),improved the variables of blood gases and decreased the water content of lung and brain,and prolonged the survival time.Conclusion HSD could be used in the treatment of hemorrhagic shock with pulmonary edema at high altitude.更多还原