中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2008年
5期
291-293
,共3页
岑坚%杨平地%沈建良%黄有章%姜涛%王大鹏%段蕴铀
岑堅%楊平地%瀋建良%黃有章%薑濤%王大鵬%段蘊鈾
잠견%양평지%침건량%황유장%강도%왕대붕%단온유
海水浸泡%低温%高渗%凝血%创伤
海水浸泡%低溫%高滲%凝血%創傷
해수침포%저온%고삼%응혈%창상
seawater immersion%low temperature%hyperosmosis%blood coagulation%trauma
目的 探讨实验犬腹部开放伤合并海水浸泡后高渗及低温对机体出凝血系统的影响.方法 20只犬致腹部开放伤后被随机分为对照组(不经过海水浸泡)和海水浸泡组,每组10只.于致伤前(0 h)及致伤后1.5(打捞出水时)、4、8和12 h检测两组内皮素-1(ET-1)、血小板α-颗粒膜蛋白140(GMP-140)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体、凝血因子Ⅱ等变化.结果 海水浸泡后PT、APTT明显延长,D-二聚体、GMP-140、ET-1明显增加,凝血因子Ⅱ活性明显降低(P均<0.05).与对照组比较,海水浸泡组ET-1、PT、APTT、D-二聚体及凝血因子Ⅱ活性均有明显变化,差异有统计学意义(P均<0.05),而GMP-140与对照组比较差异则无统计学意义(P均>0.05).结论 腹部开放伤合并海水浸泡后可损伤血管内皮细胞,活化血小板,抑制凝血因子活性,引起凝血功能障碍、血栓形成和纤溶系统激活.
目的 探討實驗犬腹部開放傷閤併海水浸泡後高滲及低溫對機體齣凝血繫統的影響.方法 20隻犬緻腹部開放傷後被隨機分為對照組(不經過海水浸泡)和海水浸泡組,每組10隻.于緻傷前(0 h)及緻傷後1.5(打撈齣水時)、4、8和12 h檢測兩組內皮素-1(ET-1)、血小闆α-顆粒膜蛋白140(GMP-140)、凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、D-二聚體、凝血因子Ⅱ等變化.結果 海水浸泡後PT、APTT明顯延長,D-二聚體、GMP-140、ET-1明顯增加,凝血因子Ⅱ活性明顯降低(P均<0.05).與對照組比較,海水浸泡組ET-1、PT、APTT、D-二聚體及凝血因子Ⅱ活性均有明顯變化,差異有統計學意義(P均<0.05),而GMP-140與對照組比較差異則無統計學意義(P均>0.05).結論 腹部開放傷閤併海水浸泡後可損傷血管內皮細胞,活化血小闆,抑製凝血因子活性,引起凝血功能障礙、血栓形成和纖溶繫統激活.
목적 탐토실험견복부개방상합병해수침포후고삼급저온대궤체출응혈계통적영향.방법 20지견치복부개방상후피수궤분위대조조(불경과해수침포)화해수침포조,매조10지.우치상전(0 h)급치상후1.5(타로출수시)、4、8화12 h검측량조내피소-1(ET-1)、혈소판α-과립막단백140(GMP-140)、응혈매원시간(PT)、활화부분응혈활매시간(APTT)、D-이취체、응혈인자Ⅱ등변화.결과 해수침포후PT、APTT명현연장,D-이취체、GMP-140、ET-1명현증가,응혈인자Ⅱ활성명현강저(P균<0.05).여대조조비교,해수침포조ET-1、PT、APTT、D-이취체급응혈인자Ⅱ활성균유명현변화,차이유통계학의의(P균<0.05),이GMP-140여대조조비교차이칙무통계학의의(P균>0.05).결론 복부개방상합병해수침포후가손상혈관내피세포,활화혈소판,억제응혈인자활성,인기응혈공능장애、혈전형성화섬용계통격활.
Objective To explore the effects of hyperosmotic fluid and low temperature on hemorrhage and coagulation system after immersion of dogs with open abdominal wounds in seawater.Methods Twenty healthy dogs were subjected to open abdominal injury, then dogs were randomized equally into two groups: the control group (n=10) (without seawater immersion) and seawater immersion group (n=10). The variables of prothrombin time (PT), partial thromboplastin time (APTT), D-dimer and factor Ⅱ , granule membrane protein-140 (GMP-140), endothelin-1 (ET-1) were determined. Results PT and APTT were significantly prolonged. D-dimer, GMP-140, and ET-1 were increased, while factor Ⅱ was decreased after the dog with open abdominal wound was immersed in seawater (all P<0.05). Compared with the variables of control group, PT, APTT, D-dimer and factor Ⅱ , ET-1 in seawater immersion group had markedly changed (all P<0.05) except GMP-140 at different time points (all P>0.05). Conclusion Obvious vascular endothelial cell dysfunction, platelet activation, inhibition of coagulation factor activity,coagulopathy, and disorders in thrombosis and fibrolysis system activation occur after dogs with open abdominal wounds are immersed in seawater.