火器多发伤时血液动力学变化特点的研究

发布时间：2018-10-18 09:51

【摘要】：目的　通过建立小型猪火器多发伤模型 ,探讨多发伤时血液动力学变化的特点。方法　采用 5 8mm子弹射击颅顶骨和双侧股骨 ,制作火器多发伤模型。 12只小型猪随机分为对照组(不致伤 )和多发伤组各 6只。观察创伤后平均动脉压 (MAP)、平均肺动脉压 (MPAP)、肺动脉嵌压(PCWP)、心输出量 (CO)、外周血管阻力指数 (SVRI)以及门静脉血流量和胃粘膜内 pH值的变化特点。结果　对照组血液动力学指标无明显变化 ;多发伤组伤后MAP一过性升高 ,4 8～ 72h出现“高排低阻”现象 :心输出量明显增加 ,平均动脉压和体循环外周阻力指数下降 (伤后 72h为 978± 6 5 ) ,MPAP和PCWP升高 ;门静脉血流量下降伤后 72h为 [(344± 84 )ml·kg-1·min-1];胃粘膜缺血缺氧。结论　火器多发伤后在无严重失血情况下也会发生全身血流重新分布 ,内脏灌流不足。
[Abstract]:Objective to study the characteristics of hemodynamic changes in multiple injuries in miniature pigs by establishing a model of multiple injuries with firearm. Methods 5 8mm bullets were used to shoot cranio-parietal bone and bilateral femur to make multiple injury model of firearm. Twelve miniature pigs were randomly divided into control group (without injury) and multiple injury group (n = 6). The changes of mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), (PCWP), cardiac output (CO), peripheral vascular resistance index (SVRI), portal vein blood flow (PVF) and gastric intramucosal pH (pH) were observed after trauma. Results there was no significant change in hemodynamic indexes in the control group, but the MAP in the multiple injury group was temporarily increased, and the phenomenon of "high output and low resistance" appeared from 48 to 72 hours. The cardiac output was increased obviously. Mean arterial pressure and peripheral resistance index of systemic circulation decreased (72h after injury, 978 卤65), MPAP and PCWP increased, portal vein blood flow decreased 72 h after injury [(344 卤84) ml kg-1 min-1], gastric mucosal ischemia and hypoxia). Conclusion the systemic blood flow will be redistributed and the visceral perfusion will be insufficient after multiple firearm injury without severe blood loss.
【作者单位】：中国人民解放军第三零四医院普外科中国人民解放军第三零四医院普外科中国人民解放军第三零四医院普外科中国人民解放军第三零四医院普外科海军总医院普外科
【基金】：全军九五指令性课题资助项目 (NO .96L0 5 3 )
【分类号】：R82

【相似文献】