参麦注射液对腹部开放伤合并海水浸泡犬血气和凝血的影响  

The effect of Shenmai Injection on blood gas and blood coagulation of dogs with abdomen injures and seawater immersion

作　　者：岑坚[1] 杨平地[1] 沈建良[1] 黄有章[1] 向丹[1] 郑培浩[1] 姜涛[2] 王大鹏[2] 

机构地区：[1]海军总医院血液科,北京100048 [2]海军总医院海战伤救治研究中心,北京100037

出　　处：《中国医药导报》2012年第32期84-86,90,共4页China Medical Herald

基　　金：海后司令部指令性课题(课题号:04-3304)

摘　　要：目的探讨犬腹部伤合并海水浸泡后高渗及低温因素对其机体血气和凝血的影响及观察参麦注射液的治疗作用,为制订海战伤早期救治提供实验依据。方法将24只犬做腹部开放伤动物模型后,随机分为三组,每组8只。对照组:腹部伤后用海水浸泡;普通治疗组:经海水浸泡后打捞出水,给予一般的急救处理;参麦治疗组:经海水浸泡后打捞出水,除给予一般的急救处理外,同时输注参麦注射液。检测指标包括:平均动脉压(MAP)、血气分析(pH、PO2、PCO2)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、内皮素-1(ET-1)。结果海水浸泡后动物MAP、pH值、PO2降低,PT、APTT明显延长,PCO2、FIB、ET-1增加。参麦注射液治疗后,MAP短暂升高,PO2明显高于对照组和普通治疗组,ET-1明显低于对照组和普通治疗组,PCO2明显低于对照组,差异有统计学意义(P<0.05);PT、APTT在参麦治疗组和普通治疗组组间比较,差异无统计学意义(P>0.05)。结论腹腔外伤合并海水浸泡可引起机体低氧血症、高碳酸血症、酸中毒、休克、凝血功能障碍和血栓形成。参麦注射液具有改善微循环、提高组织抗缺氧能力、抑制血小板聚集和血栓形成及抗休克作用,在腹部外伤合并海水浸泡的救治中有很好的治疗作用。Objective To provide theoretical evidence for the early treatment of injury with seawater immersion,to explore the effects of hyperosmosis and low temperature on dog＇s blood gas and coagulation system after a deep cut in the dog＇s abdomen with seawater immersion,and to observe the therapeutic effects of Shenmai Injection on the model.Methods 24 dogs of the model were randomized into three groups.Each group had 8 dogs.The 8 dogs in the control group were cut in abdomen with seawater immersion.The 8 dogs in the ordinary therapy group were cut in abdomen with seawater immersion and treated with emergency methods.The other 8 dogs in the Shenmai Injection group were infused with Shenmai Injection after they were cut in abdomen with seawater immersion and given emergency treatments.The indexes such as mean arteri al blood pressure,blood gas analysis（pH,PO2,PCO2） prothrombin time,activated partial thromboplastin time（APTT）,fib rinogen（FIB）,endothelin-1（ET-1） were observed.Results MAP,the value of pH,PO2 significantly decreased,while PT and APTT significantly prolonged and PCO2,FIB,ET-1 increased after the injured dogs immersed by seawater immersion.MAP were transient heighten after infused with Shenmai Injection.PO2 increased significantly and ET-1 decreased significantly in Shenmai Injection group as compared to the control group and the ordinary therapy group.PCO2 decreased significantly in Shenmai Injection group as compared to the control group（P〈0.05）.PT and APTT were not significantly different between the two groups（P〈0.05）.Conclusion The injury in the dog＇s abdomen with seawater immersion resulted in hyoxemia,hypercapnia acidosis,shock,activative blood coagulation system and microthrombosis.Shenmai Injection can improve minicirculation and has capability of anti-hypoxia,It also can inhabit platelet aggregation and thrombogenesis and has antishock effects.Shenmai Injection is an effective therapy for a deep cut in the dog＇s abdomen with seawater immer sion.

关 键 词：海水浸泡 血气 凝血 参麦注射液 

分 类 号：R969.4[医药卫生—药理学]