应用便携式连续性血液净化机救治挤压综合征犬的实验研究  

Safety and efficacy of portable continuous blood purification machine in treatment of crush syndrome：experiment with dogs

作　　者：宋洁[1] 丁辉[1] 樊毫军[1] 侯世科[1] 白斌[1] 王金墙 董文龙[1] 孙振兴[1] 

机构地区：[1]中国人民武装警察部队后勤学院附属医院救援医学研究所,天津300162

出　　处：《中国急救复苏与灾害医学杂志》2014年第9期826-829,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家卫计委重大专项课题（突发公共事件卫生应急救援现场关键技术、流程规范应用性研究（201302003）;灾害现场救援用便携式连续性血液净化机的研制（武警部队后勤部课题（WHKL-18）;武警后勤学院附属医院种子基金（FYQ201454）

摘　　要：目的：观察使用便携式血液净化机治疗挤压综合征的疗效与安全性。方法16只比格犬左后肢经受50 Kg挤压8 h制作（CS）犬动物模型，并将CS犬随机均分为实验组和对照组。实验组于挤压解除后即刻使用便携式连续性血液净化机进行的连续性静-静脉血液滤过（continuous veno-venous hemofiltration ，CVVH）治疗12 h，对照组未采取治疗措施。两组于挤压前、挤压8 h、治疗4 h、治疗8 h、治疗12 h同时间点采血检测血肌红蛋白（Mb）、血肌酐（Scr）、尿素氮（BUN）、血清钾（K＋）。结果对照组有3只犬于挤压后24 h内死于心律失常、心跳骤停。实验组犬在使用便携式连续性血液净化机治疗后血Scr、BUN、Mb及K＋均显著低于对照组，均P＜0.05。便携式连续性血液净化机使用过程中。脱水精度及置换液流量控制均符合国家行业标准要求。结论使用便携式连续性血液净化机的CVVH治疗模式可有效清除CS犬血Mb，改善肾功能，降低血K＋，治疗CS安全、有效。Objective To observe the effects and safety of portable continuous blood purification machine in treatment of crush syndrome （CS） by continuous veno-venous hemofiltration （CVVH） . Methods 16 dogs underwent compression of 50 Kg upon their left hind legs for 8 h to establish CS dog models, and then were randomly divided into 2 equal groups： experimental group underwent CVVH using portable continuous blood purification machine for 12 h, and control group without specific treatment. Blood samples were collected to examine the levels of serum creatinine （Scr）, urea nitrogen （BUN）, myoglobin （Mb）, and potassium （K ＋） at the time points before compression, 8 h after compression, and 4 h, 8 h, and 12 h after CVVH. Results 3 dogs in the control group died within 24 h after compression. All dogs in the experiment group survived to the end of experiment. There were no significant differences in the serum Mb levels between these 2 groups before and 8 h after compression. The serum Mb, Scr, BUN, and K＋levels 4 h, 8 h, and 12 h after CVVH of the experimental group were all significantly lower than those of the control group （all P〈0.05 ） . The fluid replacement volume control accuracy and dehydration accuracy of the portable continuous blood purification machine reached and even were superior to the national industry standards. All the pressure sensors worked normally. Conclusion Using portable continuous blood purification machine in CVVH treatment effectively removes the serum Mb, decrease serum K＋and improves the renal function . Its stability, safety, and effectiveness are satisfactory in the treatment of CS.

关 键 词：便携式连续性血液净化机 连续性静-静脉血液滤过 挤压综合征 动物实验 

分 类 号：R459.5[医药卫生—治疗学]