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目的探讨自然海水中火器伤血流动力学的变化特点,为海水中火器伤救治措施的制定提供模拟实际海战的实验依据。方法普通级毕格犬17只随机分为海水中致伤组(n=14)和地面致伤组(n=3)。海水组于海水中枪伤后救出,连续监测早期(53.62±12.19)分钟血流动力学变化及肛温,并采用基础救治;地面组为观察对照。结果海水中枪击伤伤后70分钟内:呼吸(R)和心率(HR)的变化趋势一致,30分钟R[(22.75±2.48)bpm]和HR[(151.00±49.93)bpm]较慢,伤后50分钟时R[(40.67±3.59)bpm]和HR[(204.03±14.08)bpm]较快,二者整体呈跳跃式加快;30分钟时收缩压(SBP)[(138.68±17.93)mmHg]、舒张压(DBP)[(97.60±18.82)mmHg]、平均动脉压(MAP)[(111.33±14.57)mmHg]较低,40~55分钟时变化幅度和波动范围比较大,60~70分钟虽有变化但波动范围小;中心静脉压(CVP)于伤后35~45分钟持续升高并达峰值,之后波动范围不大。海水中枪击伤机体体温下降比地面伤快。结论海水中枪击伤后应尽快补充容量,尽早监测血流动力学、体温,注意保温。
Objective To investigate the changes of hemodynamics of firearm wounds in natural seawater and provide experimental basis for simulating actual naval battlefield for the treatment of firearm wounds in seawater. Methods Seventeen Beagle dogs of ordinary grade were randomly divided into seawater injury group (n = 14) and ground injury group (n = 3). The seawater group was rescued after gunshot wounds in the seawater. The hemodynamic changes and rectal temperature in the early stage (53.62 ± 12.19 minutes) were monitored continuously. The ground group was used as the observation control. Results Within 70 minutes after the gunshot wound in seawater, the changes of respiratory rate and heart rate (HR) showed the same trend. After 30 minutes R [(22.75 ± 2.48) bpm] and HR [(151.00 ± 49.93) bpm] R [(40.67 ± 3.59) bpm] and HR [(204.03 ± 14.08) bpm] were faster in the last 50 minutes, and both of them were leapfrog. The systolic blood pressure (SBP) at 30 minutes [(138.68 ± 17.93) mmHg] , DBP (97.60 ± 18.82) mmHg] and mean arterial pressure (MAP) [(111.33 ± 14.57) mmHg] were lower. The range of change and fluctuation ranged from 40 to 55 minutes, and ranged from 60 to 70 minutes There was a change but a small fluctuation range; central venous pressure (CVP) continued to rise and peak from 35 to 45 minutes after injury, and the fluctuation range was not large. Shot in the sea water body temperature drops hurt faster than the ground. Conclusion The shotgun in seawater should be as soon as possible after the additional capacity, early monitoring of hemodynamics, body temperature, attention to insulation.