实验犬脾创伤急性失血性休克及复苏期的超声造影特征分析

发布时间：2018-06-14 16:36

本文选题：超声造影 + 脾脏　；参考：《中南大学学报(医学版)》2015年01期

【摘要】：目的:评价实验犬脾创伤急性失血性休克及复苏期的超声造影(contrast enhanced ultrasonography,CEUS)特征。方法:15只健康杂种犬常规麻醉,开腹制造40处脾脏III~IV级创伤出血灶,并模拟建立失血性休克及休克复苏动物模型。于休克前,休克期及休克复苏期,观察并记录活动性出血灶的CEUS表现,并与增强CT进行对照。应用CEUS动态评价失血性休克复苏前后创伤脾脏血流动力学参数(始增时间、达峰时间、峰值强度、廓清时间)的变化。结果:无论在休克前、休克期还是复苏期,CEUS与增强CT比较,创伤灶的显示率方面均无明显差异(P0.05)。休克前,40处脾脏创伤出血灶,CEUS显示34处(显示率85.0%),呈无增强和/或低增强创伤区内的异常增强。随休克进展,CEUS显示脾脏动脉的微小分支减少,呈"枯枝状",造影剂聚积于小动脉分支末梢,却无活动性出血的异常增强。复苏后,30处创伤灶再出血,CEUS显示28处(显示率93.3%)。CEUS动态监测创伤脾脏血流灌注变化,休克期血流动力学参数明显异于其他两组(P0.01),体现在始增时间,达峰时间,峰值强度明显减低,而廓清时间显著延长。结论:CEUS不仅可以动态监测失血性休克时脾创伤出血灶的变化及休克复苏期再出血的发生,还可以对实验犬脾脏血流灌注变化进行定量分析。
[Abstract]:Objective: to evaluate the characteristics of contrast enhanced ultrasonography in acute hemorrhagic shock and resuscitation stage of splenic trauma in dogs. Methods Fifteen healthy mongrel dogs were anesthetized and 40 hemorrhagic foci of grade IV trauma of spleen were made by laparotomy, and hemorrhagic shock and resuscitation animal models were established. CEUs findings of active bleeding foci were observed and recorded before shock, shock and shock resuscitation, and were compared with contrast-enhanced CT. The changes of splenic hemodynamic parameters (onset time, peak intensity, clearance time) before and after hemorrhagic shock resuscitation were evaluated by CEUs. Results: there was no significant difference in the display rate of traumatic foci between CEUs and enhanced CT before shock, shock or resuscitation. CEUs showed 34 splenic bleeding foci (85.0%) in 40 splenic trauma haemorrhagic foci before shock, showing abnormal enhancement in no enhancement and / or low enhancement trauma area. With the progression of shock, CEUs showed that the small branches of the splenic artery decreased and presented as "withered branches". Contrast agents accumulated at the end of the branches of the arterioles, but there was no abnormal enhancement of the active bleeding. After resuscitation, CEUs showed 28 cases of rebleeding in 30 trauma foci. The hemodynamic parameters in shock phase were significantly different from those in the other two groups (P 0.01), and the peak time, peak time and peak intensity were significantly decreased, and the hemodynamic parameters in shock phase were significantly different from those in the other two groups. The clearance time was significantly prolonged. Conclusion the changes of splenic hemorrhage in hemorrhagic shock and the occurrence of rebleeding in resuscitation phase can be dynamically monitored by VCEUS, and the changes of splenic blood perfusion in experimental dogs can also be quantitatively analyzed.
【作者单位】：解放军总医院南楼临床部超声科;解放军总医院超声科;山西省大同市同煤集团肿瘤医院功能科;
【基金】：国家自然科学基金(81071279) 全军医学科技青年培育项目(14QNP102)~~
【分类号】：R445.1;R459.7

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