论文部分内容阅读
目的探讨肝肺撞击伤伴失血后二氧化碳(CO_2)气腹对兔动脉血气的影响及其机制。方法制作创伤性失血兔模型,按不同失血量(6 mL/kg、12 ml/kg、22 ml/kg)及 CO_2 腹压(5 mm Hg、10 mm Hg、15 mmHg)将75只新西兰大白兔按随机数字表分为9组(每组6只)。观察建立气腹前、气腹0.5 h、2 h 及撤去气腹后0.5 h 呼吸频率(RR)、动脉血气(ABG)的变化和死亡率。结果大白兔在建立气腹前:随失血量的增加,RR、PaCO_2上升显著;pH 值先升高后降;PaO_2 则持续下降。大白兔在建立 CO_2气腹后:随时间延长,5 mm Hg、10 mm Hg 压力组的 RR 先增后降;pH 值、PaO_2持续下降,PaCO_2持续升高,而且在相同失血量的情况下各组间的 pH 值、PaO_2随压力升高而降低,15 mm Hg 气腹组 RR 及 PaCO_2显著高于其他组。在相同压力条件下,5 mm Hg、10 mm Hg 气腹压力组随失血增多RR 加快、PaCO_2增高,pH 值、PaO_2下降。撤去气腹后0.5 h,各组内 RR、PaO_2、pH、PaCO_2值向正常恢复。结论一定气腹压力(<10 mm Hg)对创伤伴失血(<12 ml/kg)自主呼吸兔 ABG 的影响是可逆的;而高气腹压力(15 mm Hg)或大白兔失血量在12 ml/kg 以上时建立气腹将引起致死性后果。
Objective To investigate the effects of carbon dioxide (CO_2) pneumoperitoneum on the arterial blood gas in rabbits with liver-lung impact injury and its mechanism. Methods Rabbit models of traumatic hemorrhage were made. 75 New Zealand white rabbits were randomly divided into three groups according to the blood loss (6 mL / kg, 12 ml / kg, 22 ml / kg) and CO 2 abdominal pressure (5 mm Hg, 10 mm Hg, 15 mmHg) According to random number table is divided into 9 groups (6 per group). The changes of respiratory rate (RR), arterial blood gas (ABG) and mortality after 0.5 h, 2 h and 0.5 h after pneumoperitoneum were established before pneumoperitoneum were established. Results Before the establishment of pneumoperitoneum in rabbits, RR and PaCO_2 increased significantly with the increase of blood loss; pH increased first and then decreased; PaO_2 decreased continuously. After establishment of pneumoperitoneum of CO_2 in rabbits, the RR of 5 mm Hg and 10 mm Hg increased first and then decreased with the increase of time; pH, PaO_2 continued to decline and PaCO_2 continued to increase, and in the same amount of blood loss PaO_2 decreased with the increase of pressure, and RR and PaCO_2 of pneumoperitoneum at 15 mm Hg were significantly higher than those of other groups. Under the same pressure conditions, the pneumoperitoneum pressure of 5 mm Hg and 10 mm Hg accelerated with the increase of blood loss, PaCO_2 increased, pH and PaO_2 decreased. After 0.5 h of pneumoperitoneum withdrawal, the values of RR, PaO 2, pH and PaCO 2 in each group recovered to normal. Conclusion The effect of pneumoperitoneum pressure (<10 mm Hg) on ABG in spontaneous resuscitation rabbits with traumatic hemorrhage (<12 ml / kg) is reversible. However, high pneumoperitoneum pressure (15 mm Hg) / kg above the establishment of pneumoperitoneum will cause fatal consequences.