胸部火器伤犬阻闭迷走神经对瞬时及早期心血管效应的影响  

Influences of obstructing vagus on instantaneous and incipient cardiovascular reactions in dogs with firearm thoracic wound

作　　者：陶登顺[1] 刘维永[2] 蔡建辉[2] 李宏[2] 李同勋[2] 郭建军[2] 安书杰[2] 

机构地区：[1]沈阳军区总医院心脏外科,辽宁沈阳110016 [2]第四军医大学西京医院心血管外科中心,陕西西安710033

出　　处：《第四军医大学学报》2002年第4期330-332,共3页Journal of the Fourth Military Medical University

基　　金：全军"九五"指令性课题 ( 96 L0 4 6 )

摘　　要：目的　探讨阻闭迷走神经对犬胸部火器伤瞬时及早期心血管效应的影响 .方法　犬 1 2只随机平分为 2组 ,A组 :模型组 ,B组 :迷走神经封闭组 .各组分别用小口径步枪致伤 ,连续监测动脉压、静脉压、心率、肺动脉压、肺毛细血管嵌压、心电图 ,按时测心排血量 ,计算体循环血管阻力和肺血管阻力 .结果　两组犬枪伤瞬间血压均即刻呈单波峰升高 ,达伤前的 (1 .2± 0 .1 )倍 (P<0 .0 5) ,而后缓慢下降 ;肺动脉压、肺嵌压亦出现相应变化 ,枪伤早期心排量减少 (1 .4± 0 .2 ) L·min-1 (P<0 .0 1 ) ,每搏量减少 (9.0± 1 .1 ) L· beat-1 (P<0 .0 1 ) ,同时体循环血管阻力增加 (64.9± 1 2 .1 ) k Pa· L-1 ·min-1 (P<0 .0 1 )和肺血管阻力增加 (1 4 .9± 3.1 ) k Pa· L-1 ·min-1 (P<0 .0 1 ) ,1 5 min左右达到顶点 ,而后逐渐恢复 .枪伤瞬间心率减慢 ,但很快恢复并逐渐加快 .B组犬枪伤瞬间上升单峰波仍然存在 ,但随后血压变化幅度较小 ,恢复亦较快 ,心率无瞬时下降 .心排量及血管阻力变化较 A组小 .AIM To confer on the influences of obstructing Vagus on instantaneous and incipient cardiovascular effects in dogs with firearm thoracic wound. METHODS Twelve dogs were randomly divided into model group (A) and obstrucling vagus group (B). All animals of each group were wounded by small bore rifle. Then the artery pressure, vein pressure, heart rate, pulmonary arterial pressure (PAP), pulmonary artery wedge pressure (PWP), ECG and cardio output (CO) were continuously monitored. The systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were calculated. RESULTS Immediately after wound, artery pressure ascended to (1.2±0.1) times of normal, then descends gradually. PAP and PWP ascend right after wound and then descend. CO descends(1.4±0.2) L·min -1 ( P < 0.01) and SV descends(9.0±1.1) L·beat -1 ( P <0.01). At the same time, SVR ascend (64.9±12.1) kPa·L -1 ·min -1 ( P <0.01)and PVR ascend (14.9±3.1) kPa·L -1 ·min -1 ( P <0.01) and reach the top after 15 min or so. Then recover gradually. Of group B, the artery pressure change was small and recovers very soon. The heart rate doesn't descend immediately. CO, SVR and PVR changes were smaller than that of group A. CONCLUSION Cardiovascular effects are related to the reflection of vagus.

关 键 词：胸部枪伤 心血管效应 迷走神经 

分 类 号：R826.5[医药卫生—临床医学]