不同浓度碘伏腹腔冲洗术对兔血流动力学及酸碱平衡的影响  

Influence of peritoneal lavage with different concentrations of povidone-iodine on hemodynamics andacid-base balance in rabbits

作　　者：廖红[1] 何伟坤 马文静 高宇博[1] 倪新莉[1] Liao Hong, He Weikun, Ma Wenjing, Gao Yubo, Ni Xinli,(Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China)

机构地区：[1]宁夏医科大学总医院麻醉科,银川市750004

出　　处：《中华麻醉学杂志》2018年第5期571-574,共4页Chinese Journal of Anesthesiology

基　　金：宁夏自然科学基金项目（NZl5165）;科技创新领军人才项目（KJT2015017）

摘　　要：目的评价不同浓度碘伏腹腔冲洗术对兔血流动力学及酸碱平衡的影响。方法清洁级健康成年雄性新西兰大白兔24只，3月龄，体重2.8～3．2kg，采用随机数字表法分为4组（n=6）：对照组（C组）、碘伏1／3原浓度组（TI组）、碘伏1／2原浓度组（HI组）和碘伏原浓度组（OI组）。腹腔注射3％戊巴比妥1．5ml／kg麻醉兔，局麻下行左股动脉置管监测有创BP，行腹腔切开。开腹后10min时C组、TI组、Hl组和OI组分别采用生理盐水、碘伏与生理盐水1：2稀释溶液、碘伏与生理盐水1：1稀释溶液和碘伏原液20ml冲洗腹腔．冲洗液腹腔留置2min后无菌纱布蘸干后关腹。于冲洗前即刻（T1）、冲洗结束后5、10、20min、1和2h（T1）时记录MAP和HR，于T0、4、5时采集股动脉血行血气分析，记录pH值、BE和乳酸水平。记录腹腔冲洗前麻醉持续时间，麻醉后2h累积麻醉用药量、补液量和尿量，记录腹腔冲洗后3h兔死亡情况．结果与C组比较，TI组、HI组和OI组T1，时MAP、T1时HR、HI组和OI组T1，时pH值降低，BE负值升高，OI组T1时乳酸水平、HI组和OI组兔死亡率升高（P〈0．05）；与TI组比较，OI组T1，时MAP、T1时pH值降低，BE负值升高，T1，时乳酸水平、HI组和OI组兔死亡率升高（P〈0．05）；与HI组比较，OI组各指标差异无统汁学意义（P〉0．05）。结论碘伏腹腔冲洗术可呈浓度依赖性致兔血流动力学恶化，酸碱平衡失调。Objective To evaluate the influence of peritoneal lavage with different concentrations of povidone-iodine on hemodynamics and acid-base balance in rabbits. Methods Twenty-four clean-grade healthy adult male New Zealand white rabbits, aged 3 months, weighing 2. 8-3.2 kg, were divided into 4 groups （ n = 6 each） using a random number table ： control group （ group C） , povidone-iodine 1/3 of origi- nal concentration group （group TI）, povidone-iodine 1/2 of original concentration group （group fti） and povidone-iodine of original concentration group （ group OI）. Rabbits were anaesthetized with intraperitoneal 3% pentobarbital 1.5 ml/kg, the left femoral artery was cannulated for invasive blood pressure monitoring, and the abdominal cavity was opened. Peritoneal lavage was performed with normal saline, povidone-iodine diluted with normal saline （ 1 ： 2 ） , povidone-iodine diluted with normal saline （ 1 ： 1 ） and original povi- done-iodine 20 ml at 10 rain after opening abdominal cavity in C, TI, HI and Ol groups, respectively. The fluid ibr peritoneal lavage was sucked out using a sterile gauze 2 rain later and then the abdominal cavity was closed. Mean arterial pressure （MAP） and heart rate （HR） were recorded immediately before lavage （T0） and at 5, 10 and 20 rain and 1 and 2 h after the end of lavage （ Tlk5 ）. Arterial blood samples were collected at To, T4 and T5 for blood gas analysis, and the pH value, BE and lactic acid level were recorded. The duration of anesthesia before peritoneal lavage, cumulative dose of anesthetics, fluid volume andurine volume at 2 h after anesthesia, and mortality at 3 h after peritoneal lavage were recorded. Results Compared with group C, MAP at Tt_5 and HR at T3_5 were significantly decreased in TI, HI and OI groups, pH value was significantly decreased and BE negative value was increased at T4,5 in HI and OI groups, the lactic acid level was significantly increased at T5 in group OI, and the mortality rate were significantly in- creas

关 键 词：腹腔灌洗 血流动力学 碘伏 酸碱平衡 

分 类 号：R61[医药卫生—外科学]