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目的观察感染性休克兔胃黏膜与动脉血二氧化碳分压差[p(g-a)(CO2)]的变化。方法日本大耳白兔16只,麻醉后压力控制通气,将动物随机分成休克组和对照组,每组各8只。休克组静脉输注稀释的大肠杆菌内毒素(2 mg/kg)复制感染性休克模型,对照组输入等量9 g/L盐水。多导生理记录仪连续监测平均动脉血压和心率。多普勒超声流量计持续测定心排出量和肠系膜上动脉血流量。气体张力测定法每10分钟测定1次胃黏膜二氧化碳分压。每小时测定Hb水平、动静脉血气分析、动脉血乳酸。结果对照组各参数维持稳定,休克组变化明显。与基础状态比较,休克组兔静脉注射内毒素后2 h,动脉血压由(78±5)mmHg降至(50±2)mmHg(1 mmHg=0.133 kPa)(F=145.3 P<0.01),心脏指数由(201±17)mL/(kg.min)降至(112±11)mL/(kg.min)(F=80.5 P<0.01),肠系膜上动脉血流指数由(20.0±1.0)mL/(kg.min)降至(10.6±1.3)mL/(kg.min)(F=60.0 P<0.05),p(g-a)(CO2)由(11.4±2.8)mmHg升至(57.4±7.1)mmHg(F=120.9 P<0.01)。氧输送则由(31.4±2.9)mL/(kg.min)降至(16.6±2.0)mL/(kg.min)(F=75.5 P<0.01),氧消耗由(11.2±1.8)mL/(kg.min)降至(5.1±0.7)mL/(kg.min)(F=46.4 P<0.01)。休克后2组各参数比较均有显著性差异(Pa<0.01)。结论p(g-a)(CO2)可作为感染性休克兔胃肠低灌注的指标。
Objective To observe the changes of partial pressure of arterial carbon dioxide (p (g-a) (CO2)] in septic shock rabbits. Methods Sixteen Japanese white rabbits were anesthetized and pressure-controlled ventilation was adopted. The animals were randomly divided into shock group and control group, with 8 rats in each group. In the shock group, a dilution of E. coli endotoxin (2 mg / kg) was infused intravenously to duplicate the septic shock model, while the control group received an equivalent dose of 9 g / L saline. Multi-channel physiology recorder continuously monitors mean arterial blood pressure and heart rate. Doppler ultrasound flowmeter continuous determination of cardiac output and superior mesenteric artery blood flow. Gas tension measurement measures gastric mucosal carbon dioxide partial pressure once every 10 minutes. Hb levels were measured hourly, arteriovenous gas analysis, arterial blood lactate. Results The parameters of the control group remained stable and the changes in shock group were obvious. Compared with basal state, arterial blood pressure decreased from (78 ± 5) mmHg to (50 ± 2) mmHg (1 mmHg = 0.133 kPa) at 2 h after intravenous injection of endotoxin in shock group (F = 145.3 P <0.01) Index decreased from (201 ± 17) mL / (kg.min) to (112 ± 11) mL / (kg.min) (F = 80.5 P <0.01) and the superior mesenteric artery index increased from (20.0 ± 1.0) mL P (ga) (CO2) increased from (11.4 ± 2.8) mmHg to (57.4 ± 7.1) mmHg to (10.6 ± 1.3) mL / mmHg (F = 120.9 P <0.01). Oxygen delivery decreased from (31.4 ± 2.9) mL / (kg · min) to (16.6 ± 2.0) mL / (kg · min) (F = 75.5 P <0.01) kg.min) to (5.1 ± 0.7) mL / (kg.min) (F = 46.4 P <0.01). After shock, the parameters of the two groups were significantly different (Pa <0.01). Conclusion p (g-a) (CO2) can be used as a marker of gastrointestinal hypoperfusion in septic shock rabbits.