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目的:观察犬腹部开放性损伤经海水浸泡后致急性心力衰竭的一系列病理生理变化。方法:以成年杂种犬为实验对象,随机分为腹部伤+海水浸泡组(A组,n=8)和单纯腹部伤组(B组,n=8)。观察实验动物致腹部开放性损伤前、后,经海水浸泡2 h及打捞出水后不同时间点心律、心率、收缩压、舒张压、平均动脉压、肺动脉楔压、中心静脉压、心输出量、心脏指数、肾素、脑钠肽等相关指标及病死率。并于致伤前及致伤后4 h行超声心动图,测定左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、每搏输出量(SV)、左室射血分数(LVEF)。结果:致伤后0.5 h至观察终点,A组犬平均动脉压均明显下降(P<0.05,P<0.01),B组犬平均动脉压无明显变化。致伤后A组犬肺动脉楔压显著上升,其中心静脉压、心输出量、心脏指数逐渐下降,打捞出水后仍继续下降(P<0.05,P<0.01),与B组比较有显著差异(P<0.05,P<0.01);B组犬腹部致伤前后其肺动脉楔压、中心静脉压、心输出量、心脏指数无明显差异;致伤后A组犬血肾素、脑钠肽水平明显升高(P<0.05,P<0.01),B组犬血肾素、脑钠肽水平无明显变化。结论:腹部开放伤合并海水浸泡致犬急性心力衰竭病理生理变化非常明显,为后续研究奠定了基础。
OBJECTIVE: To observe a series of pathophysiological changes of acute heart failure caused by open seawater immersion in dog’s abdomen. Methods: Adult mongrel dogs were randomly divided into abdominal injury + seawater immersion group (group A, n = 8) and simple abdominal injury group (group B, n = 8). Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulmonary arterial wedge pressure, central venous pressure, cardiac output, heart rate and heart rate were measured before and after open abdominal injury. Heart index, renin, brain natriuretic peptide and other related indicators and mortality. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV) and left ventricular ejection fraction (LVEF) were measured before injury and 4 h after injury. ). Results: The average arterial pressure of group A decreased significantly from 0.5 h to the end of observation (P <0.05, P <0.01), while the mean arterial pressure of group B did not change significantly. Cardiopulmonary wedge pressure was significantly increased in group A, and the central venous pressure, cardiac output and cardiac index decreased gradually (P <0.05, P <0.01), and there was a significant difference compared with that in group B P <0.05, P <0.01). There was no significant difference in pulmonary artery wedge pressure, central venous pressure, cardiac output, and cardiac index before and after abdominal injury in group B. Serum renin and brain natriuretic peptide in group A were significantly higher (P <0.05, P <0.01). There was no significant change of serum renin and brain natriuretic peptide in group B Conclusion: The pathophysiological changes of acute heart failure caused by open abdominal wound combined with seawater immersion are very obvious, which lays the foundation for the follow-up study.