实验性肝脏撞击伤后家兔心肌收缩功能和动脉血气的变化  

Experimental study on changes in myocardial systolic function and arterial blood gases after impact injury to liver in rabbits

作　　者：孙士锦[1] 麻晓林[1] 周学武[2] 刘良明[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所创伤中心,重庆400042 [2]第三军医大学大坪医院研究所二室,重庆400042

出　　处：《中国危重病急救医学》2005年第9期541-543,共3页Chinese Critical Care Medicine

基　　金：重庆市科研基金资助项目(8104)

摘　　要：目的探讨肝脏撞击伤对家兔心肌收缩功能和动脉血气的影响。方法建立肝脏撞击伤动物模型,分别在伤前,伤后即刻、0.5、1、2h或死亡前测定家兔心肌收缩功能和动脉血气变化。结果肝脏损伤后,心率(HR)、左室收缩压(LVSP)、左室内压最大变化速率(±dp/dtmax)均显著下降,左室舒张末压(LVEDP)差异无显著性。伤后pH值降低,HCO-3显著下降,细胞外液剩余碱(BEecf)负值逐渐增大,表现为渐进性代谢性酸中毒;动脉血二氧化碳分压(PaCO2)伤前与伤后差异无显著性,动脉血氧分压(PaO2)逐渐降低,但伤后0.5h及1h与伤前比较差异无显著性。结论肝脏撞击伤后,心肌收缩功能下降,酸碱平衡紊乱,表现为代谢性酸中毒。Objective To explore the effects of impact injury of liver on myocardial systolic function and arterial blood gases in rabbits. Methods A model of hepatic impact injury was reproduced in rabbits by hitting the xiphoid area with two falling steel balls. Myocardial systolic function and arterial blood gases were measured respectively before injury, immediately and 0. 5, 1, 2 hours after injury, and before the death. Results After injury, heart rate （HR）, left ventricular systolic pressure （LVSP）, the maximum change rate of left ventricular pressure rise and fall （±dp/dt max） descended significantly, while left ventricular end -diastolic pressure （LVEDP） showed no statistically significant change. At the same time, blood pH and HCO3^- fell gradually, and negative base excess （BEecf） showed a significant increase, indicating metabolic acidosis gradually developed. There was no obvious significant difference in partial pressure of carbon dioxide in artery （PaCO2） between the values before and after injury. Partial pressure of oxygen in artery （PaO2） decreased gradually, but no significant differences were found between the values of 0.5 hour and 1 hour after injury and that before injury. Conclusion After hepatic impact injury, myocardial systolic function deteriorates, metabolic acidosis appears.

关 键 词：肝脏 撞击伤 心肌收缩功能 动脉血气 家兔 动脉血气变化 肝脏撞击伤 实验性 左室舒张末压 代谢性酸中毒 

分 类 号：R657.3[医药卫生—外科学]