海水浸泡对火器伤合并失血性休克犬血气及酸碱平衡的影响  

Effects of seawater immersion on the blood gas and acid-base status of dogs subjected to gun shot combined with hemorrhagic shock

作　　者：卢青军[1] 陆松敏[1] 刘建仓[1] 李萍[1] 郭素清[1] 

机构地区：[1]中国人民解放军第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《中国急救医学》2003年第10期690-691,共2页Chinese Journal of Critical Care Medicine

摘　　要：目的　探讨 2 1℃海水浸泡对火器伤合并失血性休克犬血气及酸碱平衡的影响。方法　健康雄性家犬 16只 ,随机分为 2组 ;海水浸泡创伤休克组和陆地创伤休克组 ,应用滑膛枪发射钢珠球射击右侧后肢 ,然后左侧股动脉快速放血使血压降至 4 0mmHg ,维持低血压 1h后 ,动物分别置于 2 1℃海水浸泡和陆地观察 ,测定伤前、枪弹伤休克后、海水浸泡或陆地观察1、3、5h血气参数。结果　海水浸泡创伤休克组动物动脉血pH、细胞外液碱剩余 (BE -ECF)、血液碱剩余 (BE -B)、标准碳酸氢根浓度 (SBC)、碳酸氢根 (HCO3 -)和氧分压 (PaO2 )、氧饱和度 (SaO2 )呈进行性下降 ,显著低于陆地创伤休克组 ;二氧化碳分压(PaCO2 )呈进行性升高 ,显著高于陆地创伤休克组。结论　海水浸泡可以加重火器伤合并失血性休克犬酸中毒和缺氧。Objective To investigate the effects of 21℃ seawater immersion on the blood gas and acid-base status of dogs subjected to gun shot combined with hemorrhagic shock.Methods 16 male dogs were randomly divided into two groups:21℃ seawater immersion traumatic shock group(n=8) and land traumatic shock group (n=8).The dog's thighs were shot by a smooth-bore rifle with steel balls, and then were bled from femoral artery untill the mean arterial pressure(MAP) to 40 mmHg(5.3 kPa),MAP were maintained for 1 hour.At preshock,1,3,5 hours after immersion in 21℃ seawater,the pH,base excess of blood(BE-B),base excess of extracellular fluid (BE-ECF),standard bicarbonate concentration(SBC),bicarbonate(HCO_3 -),partial pressure of oxygen(PaO_2),oxygen saturation(SaO_2) and partial pressure of carbon dioxide(PaCO_2) were determined.Results The pH,BE-ECF,BE-B,SBC,HCO_3 -,PaO_2,SaO_2 of seawater immersion traumitic shock group's dogs were continuously decreased as compared with land traumatic shock group( P <0.05 or 0.01).But the PaCO_2 were significantly increased( P <0.05 or 0.01,vs land traumatic shock group).Conclusion 21℃ seawater immersion could cause more severe acidosis and hypoxia of dogs with gun shot and hemorrhagic shock.

关 键 词：失血性体克 枪弹伤 海水浸泡 

分 类 号：R82[医药卫生—临床医学]