家兔失血过程中的组织缺氧  

Observation on the Changes of the Tissue Hypoxia in the Rabbits During Graded Progressive Hemorrhage

作　　者：张岩[1] 蒋鸿鑫[1] 陈玥[1] 

机构地区：[1]首都医科大学附属北京友谊医院实验中心

出　　处：《首都医科大学学报》2008年第4期479-482,共4页Journal of Capital Medical University

摘　　要：目的了解兔失血过程中血气变化和组织缺氧情况。方法用血气分析仪测量家兔(n=10)失血过程中动脉和混合静脉(右心室血)血气变化,比较血pH值、动脉血Hb与血乳酸浓度变化的关系。结果随心输出量(Q)降低,动-静脉pH差(AVpH)、动-静脉H+差(AVH+)、动-静脉二氧化碳分压差(AVPCO2)进行性增大,血乳酸浓度逐渐升高。失血量和AVpH、AVH+、AVPCO2以及血乳酸浓度呈相关关系,三者拐折点基本相同。此拐折点相当于临界供氧量(DO2-crit)。结论AVpH和AVPCO2突然增大提示组织缺氧的开始,可用于监测组织氧合情况。Objective To understand the changes of the blood gas and the tissue hypoxia in rabbits during graded progressive hemorrhage. Methods The values of arteriovenous pH and PCO2 gradients （ AVpH and AVPCO2 ） were compared with that of blood lactate in their relationship to changes in tissue oxygen delivery （ DO2 ） in 10 rabbits during graded progressive hemorrhage. Results AVpH, AVH^＋ and AVPCO2 increased progressively as cardiac output（Qt） decreased, at the same time the blood lactate concentration increased. The relationship between cumulative blood loss, AVpH, AVH^＋ , AVPCO2 and blood lactate concentration was biphasic ; In the early stage of hemorrhage, AVpH, AVH^＋ , AVPCO2 gradients and blood lactate concentration changed gradually and later these variables changed more rapidly . The inflection points in all cases were similar. The inflection point corresponds to the critical DO2 （DO2-crit）. Conclusion Rapidly expanding AVpH and AVPCO2 indicates the onset of tissue hypoxia, which may serve as a repress reliable parameters of tissue hypoxia during hypoperfusion.

关 键 词：动-静脉血pH差 动静脉二氧化碳分压差 组织缺氧 血流灌注不足 

分 类 号：R594.3[医药卫生—内科学]