中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2011年
10期
1067-1071
,共5页
张成%高广荣%蒋会勇%吕晨光%张宝磊%谢名双%张智丽%余莉%张雪峰
張成%高廣榮%蔣會勇%呂晨光%張寶磊%謝名雙%張智麗%餘莉%張雪峰
장성%고엄영%장회용%려신광%장보뢰%사명쌍%장지려%여리%장설봉
失血性休克%环境低温%血流动力学%氧代谢%麻醉%猪%核心体温%预后
失血性休剋%環境低溫%血流動力學%氧代謝%痳醉%豬%覈心體溫%預後
실혈성휴극%배경저온%혈류동역학%양대사%마취%저%핵심체온%예후
Hemorrhagic shock%Environmental hypothermia%Hemodynamics%Oxygen metabolism%Anesthesia%Swine%Core temperature%Prognosis
目的 探讨环境低温对非麻醉猪失血性休克血流动力学及氧代谢的影响.方法 沈阳军区总医院动物中心提供的巴马香猪16头随机(随机数字法)分为:室温休克组和低温休克组,每组8头.按30 mL/kg放血建立失血性休克模型,记录建模前及建模后4h内不同时点的核心体温、心率、平均动脉压、中心静脉压、心输出量、混合静脉血氧饱和度及血气等变化,并计算氧摄取率、氧供指数和氧耗指数.采用SPSS11.0软件包行计量资料的成组t检验.结果 模型建立后室温组动物的核心体温略有下降,环境低温使核心体温下降更加明显.低温组动物的病死率较室温组明显增加(P<0.05).休克导致氧供和氧耗明显下降.室温组和低温组的血流动力学指标、氧供和氧耗的差异无统计学意义,但两者在pH值、乳酸和氧提取率上差异具有统计学意义(P<0.05).结论 环境低温加重了失血性休克后的氧代谢紊乱,使预后进一步恶化.
目的 探討環境低溫對非痳醉豬失血性休剋血流動力學及氧代謝的影響.方法 瀋暘軍區總醫院動物中心提供的巴馬香豬16頭隨機(隨機數字法)分為:室溫休剋組和低溫休剋組,每組8頭.按30 mL/kg放血建立失血性休剋模型,記錄建模前及建模後4h內不同時點的覈心體溫、心率、平均動脈壓、中心靜脈壓、心輸齣量、混閤靜脈血氧飽和度及血氣等變化,併計算氧攝取率、氧供指數和氧耗指數.採用SPSS11.0軟件包行計量資料的成組t檢驗.結果 模型建立後室溫組動物的覈心體溫略有下降,環境低溫使覈心體溫下降更加明顯.低溫組動物的病死率較室溫組明顯增加(P<0.05).休剋導緻氧供和氧耗明顯下降.室溫組和低溫組的血流動力學指標、氧供和氧耗的差異無統計學意義,但兩者在pH值、乳痠和氧提取率上差異具有統計學意義(P<0.05).結論 環境低溫加重瞭失血性休剋後的氧代謝紊亂,使預後進一步噁化.
목적 탐토배경저온대비마취저실혈성휴극혈류동역학급양대사적영향.방법 침양군구총의원동물중심제공적파마향저16두수궤(수궤수자법)분위:실온휴극조화저온휴극조,매조8두.안30 mL/kg방혈건립실혈성휴극모형,기록건모전급건모후4h내불동시점적핵심체온、심솔、평균동맥압、중심정맥압、심수출량、혼합정맥혈양포화도급혈기등변화,병계산양섭취솔、양공지수화양모지수.채용SPSS11.0연건포행계량자료적성조t검험.결과 모형건립후실온조동물적핵심체온략유하강,배경저온사핵심체온하강경가명현.저온조동물적병사솔교실온조명현증가(P<0.05).휴극도치양공화양모명현하강.실온조화저온조적혈류동역학지표、양공화양모적차이무통계학의의,단량자재pH치、유산화양제취솔상차이구유통계학의의(P<0.05).결론 배경저온가중료실혈성휴극후적양대사문란,사예후진일보악화.
Objective To investigate the effects of environmental hypothermia on hemodynamics and oxygen metabolism in unanesthetized swine model of hemorrhagic shock.Methods A total of 16 Bama pigs provided by animal experiment centre of the General Hospital of Shenyang Military Command were randomized into two groups ( n =8,each):ambient temperature (A) and hypothermia ( H ).Venous blood (30 mL/kg) was continously withdrawn over 15 minutes to establish hemorrhagic shock model.Core temperature,heart rate,mean arterial pressure,central venous pressure,cardiac output,saturation of mixed venous blood and blood gas analysis were recorded at the baseline and different hemorrhagic shock time.DO2I and VO2I,and the O2 extraction ratio (O2ER) were calculated.Results Core body temperature in group A decreased slightly after hemorrhagic shock model had established and environmental hypothermia resulted in more reduction in core body temperature.The mortality rate was significantly higher in group H (50%) than in group A (0%) (P <0.05).DO2I and VO2I decreased significantly after hemorrhage.No difference was found in hemodynamics,DO2I and VO2I between group A and group H,but the difference of pH,lactic acid and O2ER were significant between the two groups (P < 0.05 ).conclusions Environmental hypothermia aggravated the disorder of oxygen metabolism after hemorrhagic shock,which was associated with poor prognosis.