为何白蛋白可能不起作用

来源 :国外医学.输血及血液学分册 | 被引量 : 0次 | 上传用户:shhgay
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期塔林氏原理常常指的是毛细血管动脉端流体静力压大于(血浆蛋白产生的)肿胀压,故液体从动脉端处漏出,而静脉端肿胀压大于流体静力压时,液体被重吸收入静脉端。组织间隙滞留少许过剩液体(漏出液体大于重吸收液时)可通过淋巴引流从组织间隙排除。在低血量休克时理论上宁可给以白蛋白溶液,也不愿输晶体溶液,因为这样提高了从组织间隙重吸收液体,所以液体能在血管系统中保持较长时间。 但是,近年来评估毛细血管静脉端重吸收存在异议。现有良好证据显示:除了肠及肾循环外,毛细血管静脉端没有证实重吸收。相反,从毛细血管滤出的一定小量液体却被血浆蛋白渗透压制止。在某些罕见情况下,如低血量休克时,有一过性液体 The Tallinn principle is often referred to as the hydrostatic pressure at the arterial end of the capillary larger than the swelling pressure (produced by plasma proteins), so the fluid leaks out of the arterial end and the venous end swelled pressure is greater than the hydrostatic pressure and the fluid is reabsorbed Into the vein end. Tissue interstitial retention of a small excess liquid (leakage of fluid greater than the reabsorption time) can be removed from the interstitial space by lymphatic drainage. Theory of hypotonic shock would rather be given albumin solution, but also do not want to lose crystal solution, because this improves the reabsorption of liquid from the interstitial space, so the liquid can remain in the vascular system for a long time. However, there have been objections to evaluate capillary venous end-reabsorption in recent years. The available good evidence shows that in addition to intestinal and renal circulation, capillary venous end did not confirm reabsorption. In contrast, a small amount of fluid filtered from the capillaries is stopped by the osmotic pressure of plasma proteins. In some rare cases, such as hypovolemic shock, there is a transient fluid
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