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目的 :探讨胸部火器伤瞬时及早期心血管效应的神经机制 .方法 :1 8只家兔随机平分为 3组 ,A组 :模型组 ;B组 :迷走神经切断组 ;C组 :减压神经切断组 .分别用小口径步枪致伤 ,连续监测枪伤瞬间及早期心血管反应 .结果 :A组家兔枪伤瞬间血压即刻均呈单波峰升高 ,达伤前的 1 .4 7± 0 .0 9倍 ,而后迅速降低至伤前的 0 .4 8± 0 .0 6倍 ,1min后回升至伤前的 0 .80± 0 .0 7倍 ,并逐渐稳定 .心率、左室内压和±dp/dtmax出现瞬时下降且恢复缓慢 .B组枪伤瞬间血压变化幅度较小 ,恢复较快 .心率无瞬时下降 .C组枪击瞬间出现血压降低 ,幅度较A组小 ,心率变化与B组相似 .结论 :胸部枪伤后数秒内血压下降、心动过缓 ,心肌受抑制和左室内压下降与迷走神经反射有关 .切断迷走神经和减压神经可以阻断或减轻上述变化 .
Objective: To explore the neural mechanism of transient and early cardiovascular effects of chest firearm.Methods: 18 rabbits were randomly divided into 3 groups: group A: model group; group B: vagotomy group; group C: decompressive nerve transection group .And the small-caliber rifles were used to make the injury and the instantaneous gunshot wounds and the early cardiovascular reaction were monitored continuously.Results: In group A, the instantaneous blood pressure of gunshot wounds instantly increased to 1.47 ± 0. 0 9 times, and then rapidly decreased to 0.48 ± 0.06 times before injury, then rose to 0 .80 ± 0.07 times before injury and gradually stabilized after 1 minute.The heart rate, left ventricular pressure and ± dp / dtmax appeared instantaneous decline and slow recovery.B group instantaneous blood pressure changes smaller amplitude, recovery faster heart rate without instantaneous drop.C group shot instantaneous blood pressure was lower amplitude than A group, heart rate changes and B group similar. CONCLUSIONS: Blood pressure reduction, bradycardia, myocardial suppression and left ventricular pressure drop are associated with vagal reflexes within seconds after chest trauma, and cutting off the vagus nerve and decompression nerve can block or alleviate these changes.