麻醉对猪失血性休克模型血流动力学及氧动力学的影响
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麻醉对猪失血性休克模型血流动力学及氧动力学的影响 张成;高广荣;张宝磊;蒋会勇;吕晨光;谢名双;张智丽;余筣;张雪峰 【期刊名称】《中国急救医学》 【年(卷),期】2011(031)010 【摘 要】Objective To investigate the effects of anesthesia on hemodynamics and oxygen dynamics in a porcine model of hemorrhagic shock. Methods 16 Bama pigs were randomized into Lwo groups (n = 8, each); Aneslhesia (A) and Unanesthetized ( U). Venous blood (30 mL/kg) was conlinously withdrawn over 15 min in anesthetized and unanesthetized swine to establish hemorrhagic shock model. Pulmonary arterial temperature (Tp) , heart rate(HR) , mean arterial pressure (MAP) , Pulmonary arterial pressure( PAP) , pulmonary arterial wedge pressure( PAWP) , central venous pressure (CVP) , cardiac output(CO) , hemoglobin(Hb) , saturation of mixed venous blood(SvO2) and blood gas analysis were recorded at the baseline and different hemorrhagic shock time ( HST). The whole body oxygen delivery indices, DO2I and VO2I, and the O2 extraction ratio(O2ER) were calculated. Results Core body temperature in group U decreased slightly after hemorrhagic shock model had been established and anesthesia resulted in more reduction in core body temperature. No difference was found in HR, MAP, PaO2, PaCO2 and pH between group A and group U, but unanesthetized animals had significantly higher levels of lactate. DO2I and VO2I decreased significantly after hemorrhage, but DO2I, VO2I and O2ER in group U were significantly higher than group A at the baseline and different hemorrhagic shock time(HST). Conclusion Anesthesia attenuated the disorder of oxygen metabolism after hemorrhagic shock, which might be the results of induced hypothermia caused by anaesthesia.%目的 探讨麻醉对猪失血性休克血流动力学及氧动力学的影响.方法 巴马香猪16头随机分为:麻醉休克组和清醒休克组,每组8头.按30 mL/kg放血建立失血性休克模型,记录建模前及建模后4 h内不同时点的核心体温、心率(HR)、平均动脉压(MAP)、肺动脉压(PAP)、肺动脉楔压(PAWP)、中心静脉压(CVP)、心输出量(CO)、血红蛋白(Hb)、混合静脉血氧饱和度(SvO2)及血气分析变化,并计算氧摄取率(O2ER)、氧供指数(DO2I)和氧耗指数(VO2I).结果 模型建立后清醒组动物核心体温略有下降,但麻醉组动物核心体温下降更加明显.两组的HR、MAP、PaO2、PaCO2及pH值未表现出明显差异,但清醒组乳酸水平明显高于麻醉组.尽管模型建立后两组的DO2I和VO2I都出现了相同幅度的下降,但清醒组的DO2I、VO2I和O2ER在模型建立前后都显著高于麻醉组.结论 麻醉可以减轻失血性休克后的氧代谢紊乱,麻醉引起的诱导性低温可能是造成这种现象的原因. 【总页数】5页(P892-896) 【作 者】张成;高广荣;张宝磊;蒋会勇;吕晨光;谢名双;张智丽;余筣;张雪峰 【作者单位】110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科 【正文语种】中 文 【相关文献】 1.普鲁卡因氯胺酮静脉复合麻醉对失血性休克犬体循环和冠脉循环血流动力学及心肌代谢的影响2.环境低温对失血性休克猪血流动力学及氧动力学的影响3.7.5%氯化钠对重度创伤失血性休克病人麻醉诱导时血流动力学的影响4.异羟戊酸复合高渗盐对失血性休克模型大鼠血流动力学的影响5.神经安定镇痛普鲁卡因静脉复合麻醉对失血性休克犬体循环和冠脉循环血流动力学及心肌代谢的影响 因版权原因，仅展示原文概要，查看原文内容请购买 本文来源：https://www.wddqw.com/doc/cb902f2a862458fb770bf78a6529647d272834f8.html