中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2001年
5期
281-283
,共3页
创伤和损伤,火器%胸%肾上腺素%去甲肾上腺素
創傷和損傷,火器%胸%腎上腺素%去甲腎上腺素
창상화손상,화기%흉%신상선소%거갑신상선소
目的了解兔胸部火器伤血浆中肾上腺素（epinephrine， E）和去甲肾上腺素(norepinephrine， NE )变化规律及在伤后应激反应中的作用。方法将24只家兔随机分为:单纯胸腔贯穿伤组(A组)、假致伤组(B组)和正常对照组(C组)。射击前A、B组右颈总动脉及右颈外静脉插管、C组耳中动、静脉头皮针穿刺接八道生理记录仪测压。伤前5 min、伤后5，30 min、1，3，6，12，24 h取动脉血 2 ml离心出血浆，采用高效液相色谱仪（high-performance liquid chromatography， HPLC）与电化学分析（electrochemical detection， ED）检测 E及NE含量。结果 (1)A组E及NE于伤后30 min达伤前4.13和3.45倍，分别于伤后1，3 h降至最低点，为伤前 2.57和 0.47倍，于6 h达第二高峰，为伤前 4.14和 3.68倍，24 h后降至伤前水平；B、C组E及NE比较，差异无显著性意义（P>0.05）。 (2)A组动、静脉压致伤瞬间（ 2 ms内）升高，平均达伤前的1.8和6.8倍，迅即下降至伤前水平，随后缓慢下降，分别于伤后30， 5 min降至最低点（伤前的0.63和 0.25倍），之后缓慢回升，6，12 h接近伤前水平；B、C组动、静脉压比较，差异无统计学意义（P>0.05）。结论兔胸部火器伤后血浆中 E和NE均显著升高；二者浓度变化主要源自创伤后失血及组织损伤，且与伤情轻重关系密切，可作为胸部火器伤后早期伤情程度的判断标准。
目的瞭解兔胸部火器傷血漿中腎上腺素（epinephrine， E）和去甲腎上腺素(norepinephrine， NE )變化規律及在傷後應激反應中的作用。方法將24隻傢兔隨機分為:單純胸腔貫穿傷組(A組)、假緻傷組(B組)和正常對照組(C組)。射擊前A、B組右頸總動脈及右頸外靜脈插管、C組耳中動、靜脈頭皮針穿刺接八道生理記錄儀測壓。傷前5 min、傷後5，30 min、1，3，6，12，24 h取動脈血 2 ml離心齣血漿，採用高效液相色譜儀（high-performance liquid chromatography， HPLC）與電化學分析（electrochemical detection， ED）檢測 E及NE含量。結果 (1)A組E及NE于傷後30 min達傷前4.13和3.45倍，分彆于傷後1，3 h降至最低點，為傷前 2.57和 0.47倍，于6 h達第二高峰，為傷前 4.14和 3.68倍，24 h後降至傷前水平；B、C組E及NE比較，差異無顯著性意義（P>0.05）。 (2)A組動、靜脈壓緻傷瞬間（ 2 ms內）升高，平均達傷前的1.8和6.8倍，迅即下降至傷前水平，隨後緩慢下降，分彆于傷後30， 5 min降至最低點（傷前的0.63和 0.25倍），之後緩慢迴升，6，12 h接近傷前水平；B、C組動、靜脈壓比較，差異無統計學意義（P>0.05）。結論兔胸部火器傷後血漿中 E和NE均顯著升高；二者濃度變化主要源自創傷後失血及組織損傷，且與傷情輕重關繫密切，可作為胸部火器傷後早期傷情程度的判斷標準。
목적료해토흉부화기상혈장중신상선소（epinephrine， E）화거갑신상선소(norepinephrine， NE )변화규률급재상후응격반응중적작용。방법장24지가토수궤분위:단순흉강관천상조(A조)、가치상조(B조)화정상대조조(C조)。사격전A、B조우경총동맥급우경외정맥삽관、C조이중동、정맥두피침천자접팔도생리기록의측압。상전5 min、상후5，30 min、1，3，6，12，24 h취동맥혈 2 ml리심출혈장，채용고효액상색보의（high-performance liquid chromatography， HPLC）여전화학분석（electrochemical detection， ED）검측 E급NE함량。결과 (1)A조E급NE우상후30 min체상전4.13화3.45배，분별우상후1，3 h강지최저점，위상전 2.57화 0.47배，우6 h체제이고봉，위상전 4.14화 3.68배，24 h후강지상전수평；B、C조E급NE비교，차이무현저성의의（P>0.05）。 (2)A조동、정맥압치상순간（ 2 ms내）승고，평균체상전적1.8화6.8배，신즉하강지상전수평，수후완만하강，분별우상후30， 5 min강지최저점（상전적0.63화 0.25배），지후완만회승，6，12 h접근상전수평；B、C조동、정맥압비교，차이무통계학의의（P>0.05）。결론토흉부화기상후혈장중 E화NE균현저승고；이자농도변화주요원자창상후실혈급조직손상，차여상정경중관계밀절，가작위흉부화기상후조기상정정도적판단표준。
Objective To investigate the changes of plasma epinephrine (E) and norepinephrine (NE) in rabbits with firearm thoracic wounds. Methods A total of 24 rabbits were divided into 3 groups randomly, the simple thoracic penetrating injury group (Group A, n = 8), the pseudo-injury group (Group B, n = 8)and the normal control group ( Group C, n = 8). The pressures of carotid artery and jugular vein were recorded by eight-road physiological recorder at 5 minutes before injury. And the concentrations of plasma E and NE were detected through high-performance liquid chromatography (HPLC) and electrochemical detection (ED) at 5 minutes, 30 minutes, 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after injury in all the rabbits. Results The concentrations of plasma E and NE in Group A were significantly higher than those of Group C (P<0.01) and changed regularly. There was no significant difference between Group B and Group C. The pressures of carotid artery and jugular vein of Group A increased by 1.8 and 6.8 times, respectively, during 2 millisecond after injury, then decreased to normal immediately. They decreased to the minimum (0.63 and 0.25 time, respectively) in 30 minutes and 5 minutes respectively and averagely, and raised to normal slowly after 6 hours and 12 hours respectively and averagely. There was no significant difference between Group B and Group C. Conclusions The concentrations of plasma E and NE increase significantly in the rabbits with thoracic firearm wounds. Their changes have close relationship with the severity of wound and can be used as a judging criterion during the early period of wound.
