血液稀释合并控制性降压对猫小肠血流灌注及氧代谢的影响  

Effects of hemodilution alone and combined with sodium nitroprusside induced hypotension on intestinal blood flow and oxygen metabolism in anesthetized cats

作　　者：莫利求[1] 谭洁芳[1] 伍建林[1] 张辉[1] 

机构地区：[1]中山医科大学第一医院麻醉科,广州市510080

出　　处：《中华麻醉学杂志》1999年第6期365-367,共3页Chinese Journal of Anesthesiology

摘　　要：目的　探讨急性中度等容性血液稀释及其合并控制性降压对小肠血流灌注及氧代谢的影响。方法　观察１５ 只雄性家猫在急性中度等容性血液稀释后，肠系膜上动脉血流量（ＳＭＡＢＦ）、小肠氧供量、氧耗量、氧摄取率和乳酸生成量的变化，及其合并硝普钠控制性降压４０％ ，持续３０ 分钟后上述各指标的变化情况。结果　急性中度等容性血液稀释，ＳＭＡＢＦ增加４０％ （Ｐ＜ ０．０１），小肠氧供量、氧摄取率、氧耗量以及小肠乳酸生成量无明显改变；合并控制性降压后，ＳＭＡＢＦ下降４２％ （Ｐ＜０．０１），氧供量减少４０％ （Ｐ＜ ０．０１），氧摄取率增加８０％ （Ｐ＜ ０．０１），３０ 分钟后氧耗量减低伴有乳酸增加（Ｐ＜ ０．０５）。结论　急性中度等容性血液稀释增加猫小肠血流灌注，不影响正常氧代谢，但合并硝普钠控制性降压可造成小肠氧供需平衡代偿失调。Objective To investigate the effects of acute normovolemic hemodilution and combination with sodium nitroprusside (SNP) induced hypotension on intestinal blood flow,oxygen delivery and consumption in cats Methods Fifteen domestic cats were hemodiluted with polygelatin to reduce the initial hemoglobin level (123g/L) to 84g/L Superior mesenteric arterial blood flow (SMABF) was measured with eletromagnetic flow metre Arterial and superior mesenteric venous blood gas were analyzed Small intestinal lactate was measured with enzyme assay Small intestinal oxygen dilivery and oxygen consumption were calculated The deliberated hypotension was carried out with SNP by 40% for 30 minutes Results Hemodilution alone caused reduction in arterial blood oxygen content,but increase by 40% in SMABF (P<0 01) The small intestinal oxygen delivery,oxygen uptake and lactate production showed no significant changes When superimposed with SNP induced hypotension,SMABF dropped by 40% markedly (P<0 01)and the small intestinal oxygen delivery decreased by 40%,(P<0 01) Oxygen uptake also decreased 30 minutes later,accompanied by increase in lactate production Conclusion Acute mediate normovolemic hemodilution increases intestinal blood flow without impairment on intestinal oxygen supply/consumption balance However,when superimposed with sodium nitroprusside induced hypotension,intestinal blood flow decrease and oxygen metabolism is impaired

关 键 词：血液稀释 控制性低血压 硝普钠 局部血流 肠 

分 类 号：R614[医药卫生—麻醉学]