外伤性纵隔气肿对犬心肺功能影响  

Impact of Traumatic Pneumomediastinum on Cardiopulmonary Function in Dogs

作　　者：高光强[1] 孙耀昌[1] 万国泰[1] 李建秋[1] 

机构地区：[1]第二军医大学附属长征医院胸外科

出　　处：《中华创伤杂志》1994年第2期64-66,共3页Chinese Journal of Trauma

摘　　要：采用成年杂种犬１２条（１条人工胸膜粘连后），前上纵隔插管，缓慢注气，观察纵隔气肿前后的血流动力学和血气变化。实验观察到纵隔气肿使上、下腔静脉压升高，回心血量减少，心排量下降。纵隔气肿不仅影响体循环，而且影响肺循环，压迫肺静脉，致使肺淤血、水肿。动脉血氧分压和血氧饱和度亦下降，肺内分流增加。实验证明，胸膜粘连犬经颈部纵隔切开引流后，其张力得到缓解，血气和血流动力学得到改善。Twelve adult mougrel dogs (1 pleural cavities adhered dog included) were anesthetized with pentobarbital, and cathetered from the jugulum passing through the para tracheal fascia into the visceral space of the upper mediastinum, into which air was injected slowly, with constant recording of the mediastinal pressure and the investigation of the hemodynamics and blood gases. After pneumomediastinum (PM), compared with the baseline measurements, the venacavo pressure raised and the cardiac output decreased significantly. This result suggests that the PM compresses the vena cavea, the pulmonary vein and the heart, and induces a decrease of blood return to the heart and a deterioration of cardiac function. Measurements of blood gasses also changed significanttly in company with a decrease of PaO 2 and a increase of Qs/Qt. The cavities adhered dog and the 4 normal dogs developed tension pneumomediastinum. Cervical mediastinotomy only relieved the former dog.

关 键 词：纵隔气肿 心排量 肺内分流分数 

分 类 号：R655.5[医药卫生—外科学]