腹腔扩容术对猪休克复苏后腹腔高压症心脏的影响  

Effect of intra-abdominal volume increment on heart for the treatment of intra-abdominal hyper- tension after hemorrhagic shock resuscitation in minipigs

作　　者：刘道城[1] 谭浩[1] 张连阳[1] 宗北文[1] 杜文华[1] 王正刚[1] 王翔[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军战创伤中心创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《中华实验外科杂志》2012年第8期1447-1449,共3页Chinese Journal of Experimental Surgery

基　　金：国家科技支撑计划“创伤和重症急救技术研究”资助项目（2012BA111B00）

摘　　要：目的观察腹腔扩容术对腹腔高压症（IAH）心脏影响。方法建立失血性休克、门静脉不全阻断复苏后猪IAH模型，随机分腹腔扩容组（n=4）及似手术组（n=4），分别观察心率、平均动脉压（MAP）、缩短分数（Fs）和射血分数（EF），测心脏干湿比及苏木素一伊红（HE）染色结果。结果与休克前比，IAH后2h心率加快（154次／min比123次／min），MAP下降[110．0mmHg（1mmHg=0．133kPa）比127．5mmHg]，Fs下降（29．8％比40．4％），EF下降（55．5％比72．0％）（P〈0．05）。与IAH后2h比，腹腔扩容组手术后8h及12h较似手术组心率减慢（124次／min比156次／min，120次／rnin比156次／min）（P〈0．05）。腹腔扩容组22h后与IAH后2h比，EF上升（P〈0．05）。结论腹腔扩容术可显著改善本IAH模型的心率及EF。Objective To observe the effect of intra-abdolninal volume increment （IAVI） on heart functions with intra-abdominal hypertension （IAH）. Methods The models of hemorrhagic shock and in- complete blockage of portal vein in 8 healthy adult minipigs were successfully established and randomly di- vided into two groups： the IAVI treatment group （ n = 4） and the sham-operated group （ n = 4）. Heart rate, mean aortic pressure （MAP） , fractional shortening （FS） , ejection fraction （EF） and wet-to-dty ra- tio of heart were detected and hematoxylin-eosin staining was done. Results As compared with before shock, the heart rate at 2 h after IAH was increased （ 154 beats/rain vs 123 beats/min,P 〈0. 05） , and MAP [110.0 mmHg （1 mmHg=0.133kPa） vs. 127.5 mmHg,P〈0.05], FS （29.8% vs. 40.4%, P 〈0. 05） and EF （55.5% vs. 72.0% ,P 〈0. 05） were decreased. At 2 h after IAH, in the IAVI treat- ment group 8 h and 12 h after surgery, the heart rate （124 beats/rain vs. 156 beats/min; 120 beats/min vs. 156 beats/min） was decreased as compared with sham-operated group. As compared with 2 h after IAH, in the IAVI treatment group 22 h after surgery, EF （66.9% vs. 55.5% ,P 〈0. 05） was increased. Conclusion Intra-abdominal volmne increment can achieve a notable improvement of heart rate and EF in this model.

关 键 词：失血性休克 复苏 腹腔高压症 腹腔扩容术 心功能 猪 

分 类 号：R656[医药卫生—外科学]