小型猪烧伤早期体循环门静脉血流动力学变化  

HEMODYNAMIC CHANGES OF SYSTEMIC CIRCULATION AND PORTAL VEIN IN A PIG MODEL DURING ACUTE BURN PERIOD

作　　者：赵军[1] 杨东[1] 崔晓林[2] 郭振荣[2] 张志宏[1] 孙忠生[2] 

机构地区：[1]中国人民解放军第二0九医院,157011 [2]北京304医院

出　　处：《牡丹江医学院学报》1998年第3期3-6,共4页Journal of Mudanjiang Medical University

摘　　要：目的：烧伤早期，内脏尤其是肠遵循环血量不足已见有报道，但其机理及防止方法尚有待进一步研灾，该实验的目的是观察烧伤早期门静脉与体循环的血流量变化规律。方法：16只雄性小型猪，随机分为两组。A组（对照组）6只给予各种插管。B组（实验组）10只，制成30％面积的烧伤动物模型，伤后1h起按Parpland公式补液复苏。通过Swan－Garz导管及门静脉插管测定平均动脉区（MAP）、右房区（RAP）、平均肺动脉区（MPAP）、肺动脉楔区（PAWP）、循环阻力指数（SVRI）、门静脉区（PVP）。结果：右房区（RAP）在烧伤后；4h下降。以乳酸钠林格氏液补液复苏后8h出现回升（至正常），门静脉压力在伤后4h降至最低，伤后72h回升至正常。结论：烧伤休克复苏过程中，门静脉血流恢复晚于体循环的血流恢复，提示烧伤后胃肠道需要超出正常量的循环血量。Objective: Inadequate perfusion in splanchnic organs and especially in the gut during acute burn period has been reported, but the machanisms still remain unclear and its early preventive measures need to be further studied. The aha of this study is observation on regufority of body and portal vein hemodynamic changes during acute burn period. Methods: Sixteen male pigs were randomly assigned to one of the two groups. Group A (6 pigs) a sham burn group that was subjected to ail surgical procedures except burn. Group B (10 pigs), 30% total body surface area(TBSA ) cutaneous themal injury, and was resuscitated with Parkland formula one hour after burn. MAP, RAP, MPAP, CO, PVP, PVF, SVRI were monitored by 5F Swan - Ganz and portal vein inserted duct. Results: RAP was decreased in the 4 - hr potburn period, even when animals were resusinated with lactated Ringer's solution, increased to nomal in the 8 - hr , PVP decreased to the lowest point in the 4 - hr, increased slowly, and got to nomal level in the 72 -hr. Conclusion: In shock resuscfation portal venous blood flow recovered later than systemic hemodynamic variables. Suggesting that postburn gut needs exceed normal values.

关 键 词：烧伤 体循环 正常 早期 门静脉血流动力学 循环血量 小型猪 结论 常量 面积 

分 类 号：R644[医药卫生—外科学] R657[医药卫生—临床医学]