小型猪模拟海水浸泡冻僵后给予不同复温方法的体温后降效应观察  

Preventive effects of different re-warming methods against“body temperature after-drop”after immersion hypothermia

作　　者：刘书林 曹文 姚永杰 彭智勇 戴圣龙 李科华 林洁 司高潮 LIU Shulin;CAO Wen;YAO Yongjie;PENG Zhiyong;DAI Shenglong;LI Kehua;LIN Jie;SI Gaochao(Department of Aviation Medicine,Naval Medical Center,Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]海军特色医学中心航空医学研究室,上海200433

出　　处：《空军医学杂志》2021年第5期374-378,共5页Medical Journal of Air Force

基　　金：原总后卫生部基金资助项目(CWS11J185)。

摘　　要：目的建立动物体温后降模型,探索不同复温方法对浸泡性冻僵后"体温后降效应"的干预效果。方法配制模拟低温海水(温度为1℃),将小型猪胸部以下部位淹没于1℃的人工海水中。在小型猪的体温降到28℃时,立即将小型猪移出水面,随机分为3组,第1组为自然复温组,常温下自然复温;第2组为水浴复温组;第3组为湿热空气复温组。实时监测体温、心电图和心率等指标,分别于出水时及体温后降至最低体温时采血,测定血糖、血小板、尿素氮、肌酐、血清钾、总胆红素、乳酸脱氢酶、谷草转氨酶、肾上腺素等指标。结果3种复温方法皆有一定的体温后降。自然复温组、水浴复温组、湿热空气复温组的体温后降幅度分别为1.2、2.7、0.5℃。自然复温组、水浴复温组、湿热空气复温组的复温时间分别为100、60、70 min。自然复温组、水浴复温组、湿热空气复温组心率的下降幅度差异无统计学意义,但恢复时间分别为100、60、70 min。水浴复温组的血糖、尿素氮、肌酐、总胆红素、谷草转氨酶水平的差值皆显著高于自然复温组和湿热空气复温组,而湿热空气复温组的上述指标皆显著低于自然复温组。结论湿热空气复温在前期可有效降低体温后降的幅度,但复温的速度较水浴复温慢;而水浴复温引起的体温后降幅度较大,但复温的速度较湿热空气复温快。在实践中可综合使用2种方法,以降低体温后降风险,提高复温效率。Objective To establish an animal body temperat ure af ter-d rop model and explore the preventive effects of different re-warming methods against the"body temperature afterdrop effect"after immersion hypothermia.Methods Simulated low-temperature seawater(1℃)was prepared before the part below the breast of a mini swine was submerged in it.When the body temperature dropped to 28℃,mini swine was immediately removed from the water and randomly assigned to three groups:the naturally re-warming group,water bath re-warming group,and moist hot air rewarming group.The body temperature,electrocardiogram and heart rate were monitored in real time.Blood was collected when the animals were removed from the water.When the body temperature dropped to the lowest level after re-warming,the levels of blood sugar,platelets,urea nitrogen,creatinine,serum potassium,total bilirubin,lactate dehydrogenase,aspartate a minotransferase and adrenaline were determined.Results The three re-warming methods all resulted in a temperature after-drop.The extent of temperature after-drop in the three groups was 1.2℃,2.7℃and 0.5℃,respectively,while re-warming time was 100 min,60 min and 70 min,respectively.There was no significant difference in the level of decrease in heart rate,but the recovery time was 100 min for the natural re-warming group,60 min for the water bath rewarming group,and 70 min for the moist hot air re-warming group.The levels of blood sugar,urea nitrogen,creatinine,total bilirubin,and aspartate a minotransferase in the water bath re-warming group were significantly higher than those of the natural re-warming method group and the moist hot air re-warming group,indicating that the levels of blood sugar changed and the liver and kidney function deteriorated more significantly in the water bath re-warming group than in the other two groups.The levels of these indicators in the moist hot air re-warming group were significantly lower than those of the natural re-warming method group,suggesting that blood sugar did not change

关 键 词：航空医学 航海医学 浸泡低体温 复温方法 小型猪 体温后降 

分 类 号：R851.7[医药卫生—航空、航天与航海医学]