不同复温方式对犬腹部开放伤合并海水浸泡救治时血流动力学的影响  

Effect of various rewarming regimes on hemodynamic parameters of dogs after open abdominal injury and seawater immersion

作　　者：杨兴东[1] 王育红[1] 虞积耀[1] 姜福亭[1] 何远翔[1] 王大鹏[1] 段蕴铀[1] 

机构地区：[1]海军总医院,北京100037

出　　处：《解放军医学杂志》2004年第12期1031-1033,共3页Medical Journal of Chinese People's Liberation Army

基　　金：全军医学科研"九五"计划指令性课题资助项目 (编号 96 L0 0 4 )

摘　　要：目的　探讨不同复温方式对犬腹部开放伤合并海水浸泡救治时血流动力学的影响。方法　成年杂种犬 30只制作成腹部开放伤动物模型 ,伤后均浸泡人工海水中 ,2h后打捞出水 ,随机分为 3组。自然复温组 (n=10 ) :将动物移至温暖环境 ,靠机体自身产热自发复温 ;体表复温组 (n=10 ) :用电热毯体表加温 ;体中心复温组 (n=10 ) :1/3张盐水 4 2℃水浴 2 0min后 ,腹腔用 1/2张盐水持续灌洗 2h。观察不同复温方式对犬腹部开放伤合并海水浸泡救治时体温、心率、平均动脉压、中心静脉压和心输出量的影响。结果　自然复温组复温效果不满意 ,救治 6h后体温 34 8℃ ,未恢复正常体温 ,血压提升困难、心动过速、心输出量降低。体表复温组复温效果优于前组 ,6h后体温 36 9℃ ,接近致伤前体温 ,但血压、心率和心输出量也出现同前组类似的表现 ,只是程度较轻。体中心复温组复温效果满意 ,救治后 4h体温、平均动脉压、中心静脉压和心输出量基本恢复正常。结论　腹部开放伤海水浸泡后体温过低的救治时最好采用体中心复温方式。Objective To evaluate the effect of various rewarming regimes on rectal temperature and hemodynamic parameters of dogs after open abdominal injury and seawater immersion. Method 30 healthy dogs were subjected to open abdominal injury and 2-hour seawater immersion. Then dogs were divided into three groups: group A (n=10) received no special warming treatment, in group B(n=10) electric blanket was used to warm up to 42℃, in group C (n=10) animals were warmed by 1/3 saline solution in 42℃ for 20 minutes and continuous perfusion of the abdominal cavity with 1/2 saline solution for 2 hours. The changes in body temperature, heart rate, MAP, CVP and CO were observed before and after rescue. Results The results of group A were not satisfactory. The rectal temperature, MAP, HR and CO were not recovered to normal after 6 hours of treatment. and the rectal temperature was 34.8℃ after 6 hours. The rectal temperature rose to 36.9℃ after being rewarmed with an electric blanket in group B. The result was better than that of group A. But there was tachycardia. The effects of rewarming from hypothermia in group C was satisfied. All hemodynamic parameters and rectal temperature recovered after 4 hours treatment. Conclusion Cold seawater immersion after open abdominal injury would result to hypothermia, and intra-corporeal rewarming should be the optional treatment.

关 键 词：创伤和损伤 海水浸泡 复温 

分 类 号：R641[医药卫生—外科学] R364.2[医药卫生—临床医学]