切断迷走神经和减压神经对胸部火器伤心血管功能效应  

Effects of severing vagus nerve and depressor nerve on cardiovascular function in firearm thoracic wound

作　　者：陶登顺[1] 刘维永[2] 蔡建辉[2] 李宏[1] 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》2004年第2期186-188,共3页Journal of the Fourth Military Medical University

基　　金：军队"九五"指令性课题 (96L0 4 6)

摘　　要：目的 :探讨胸部火器伤瞬时及早期心血管效应的神经机制 .方法 :1 8只家兔随机平分为 3组 ,A组 :模型组 ;B组 :迷走神经切断组 ;C组 :减压神经切断组 .分别用小口径步枪致伤 ,连续监测枪伤瞬间及早期心血管反应 .结果 :A组家兔枪伤瞬间血压即刻均呈单波峰升高 ,达伤前的 1 .4 7± 0 .0 9倍 ,而后迅速降低至伤前的 0 .4 8± 0 .0 6倍 ,1min后回升至伤前的 0 .80± 0 .0 7倍 ,并逐渐稳定 .心率、左室内压和±dp/dtmax出现瞬时下降且恢复缓慢 .B组枪伤瞬间血压变化幅度较小 ,恢复较快 .心率无瞬时下降 .C组枪击瞬间出现血压降低 ,幅度较A组小 ,心率变化与B组相似 .结论 :胸部枪伤后数秒内血压下降、心动过缓 ,心肌受抑制和左室内压下降与迷走神经反射有关 .切断迷走神经和减压神经可以阻断或减轻上述变化 .AIM: To make clear instantaneous and incipient cardiovascular effects of firearm thoracic wound. METHODS: Eighteen rabbits were randomly divided into 3 groups, A: Model group; B: Severing of vagus nerve; C: Severing of depressor nerve. Animals were ligated the number 6 8 intercostal artery before wound. We severed the double vagus nerve in group B, and depressor nerve in group C. The animals was wounded in the same way of part one. The artery pressure, vein pressure, heart rate, LVSP and ±dp/dt max were monitored continuously. RESULTS: In group A, the artery pressure ascended immediately after wound, amount to 1.47±0.09 times of normal; then descended to 0.48±0.06 times of normal and stabled. The heart rate descended immediately and recovered slowly. The LVSP and heart rate descended immediately, but recovered very slowly. The changes of artery pressure in group B and C was smaller, and there were not obviously changes of heart rates. CONCLUSION: Blood pressure descends, heart rate is slow, myocardium withholds and LVSP descends in a few seconds after wound. They are related to the reflection of vagus nerve. It can block and relieve forenamed variety by disbranching vagus nerve and depressor nerve.

关 键 词：创伤 枪击 胸部损伤 心血管生理学 迷走神经 减压神经 

分 类 号：R826.63[医药卫生—临床医学]