浸泡性体温过低狗的呼吸功能及气体代谢研究  

STUDIES ON RESPIRATORY FUNCTION AND GAS METABOLISM IN DOGS WITH IMMERSION HYPOTHERMIA

作　　者：丁廷楷[1] 李永清[1] 唐亦奇[1] 李先进[1] 丁江舟[1] 赵长月 刘锡康 

机构地区：[1]海军医学研究所

出　　处：《海军医学杂志》1989年第1期19-23,69-70,共7页Journal of Navy Medicine

摘　　要：本研究用轻度麻醉狗浸泡于12℃冷水复制体温过低模型,观测其呼吸功能及气体代谢改变,并与心功能改变进行比较。主要测定氧耗量(■O_2)、肺泡通气量(■A)及通气效率,肺的氧弥散及氧合效率。血气及酸硷参数、心输出量(QT)及心指数(CI)等项指标。结果表明,直肠体温降至34℃及31℃时,■O_2显著增大,动静脉氧差亦明显增大而 CI 未相应增加,表明心功能相对不足;此时■A 增加而通气效率未明显改善,氧弥散及氧合效率反而降低,后者主要由于肺泡动脉氧分压差增大、肺分流率(QS/QT)增加及通气灌流比例(■A/QT)增大所致,因而动脉氧张力(PaO_2)降低,出现氧供不应求、代偿性代谢性酸中毒及暂时性呼吸性硷中毒。直肠体温降至25℃以下时,■O_2及■A 都显著降低,通气效率及氧合效率进一步恶化,■A/QT 比例减小,PaO_2进一步降低,出现失代偿的代谢陛及呼吸性酸中毒,57%的动物死于呼吸衰竭。The mild anesthetized dogs were immersed in 12℃ water until rectal temper- ature(RT)fell to 34,31,25,22 and 20℃(±0.5℃).Oxygen consumption(■O_2), pulmonar alveolar ventilation(■A),ventilative efficiency,pulmonary oxygen diffusion and oxygenation efficiency,blood gases and acid-base parameters,cardiac output,etc.were measured.The results showed that both ■O_2 and arterial-mixed venous oxygen difference significantly increased,but cardiac index did not increase appropriatly when RT fell to 34℃ and 31℃.These mean that heart function was insufficient relatively.In the same RT range,■A significantly increased, ventitative efficincy,however,was without marked improvement and pulmonary oxygen diffusion and oxygenation efficiency reduced,which were resulted from the increases in P(A-a)O_2,Pulmonary shunt(QS/QT)and ■A/QT.Therefor, PaO_2 reduced and compensative metabolic acidosis occurred.when RT fell progres- sively to and below 25℃,both■O_2 and ■A decreased significantly,the efficie- ncies of ventilation and oxygenation further declined,decompensative metabolic and respiratory acidosis developed.Finally,57% of animals died of respiratory failure.

关 键 词：浸泡性体温过低 呼吸功能 氧耗量 氧合效率 心指数 

分 类 号：R[医药卫生]