论文部分内容阅读
目的 探讨出血性休克及复苏过程中肝脏局部组织肝脏组织氧分压 (PtiO2 )、二氧化碳分压 (PtiCO2 )和酸碱度 (pHti)的变化规律及其应用价值。 方法 家兔 (兔数 =8)麻醉并放血至平均动脉压 =40mmHg(1mmHg =0 .133kPa) ,6 0min后复苏 ,维持 30min。监测PtiO2 、PtiCO2 、碳酸氢根浓度 ([HCO-3 ]ti)及pHti。 结果 休克后 ,PtiO2 逐渐下降至 0mmHg ;PtiCO2 最初缓慢升高 ,继而急剧升高 ,后又缓慢升高至 (4 1.6± 7.2 )mmHg (P <0 .0 1) ;[HCO-3 ]ti在 30min内逐渐升高至 (2 8.7± 4.3)mmol/L(P <0 .0 1) ;以后逐渐下降至 (2 6 .3± 3.7)mmol/L(P <0 .0 1) ;pHti降至(7.32± 0 .0 7) (P <0 .0 1)。复苏后PtiO2 迅速上升并稳定在 (13.0± 2 .0 )mmHg,PtiCO2 逐渐下降至(38.7± 5 .9)mmHg(P <0 .0 1) ,[HCO-3 ]ti逐渐上升至 (2 7.7± 4.0 )mmol/L (P <0 .0 1) ,pHti逐渐升高至 7.40± 0 .0 8(P <0 .0 1)。 结论 出血性休克时PtiO2 、PtiCO2 和pHti有一定的变化规律 ,对这些指标的监测有利于判断休克的发展、预后及治疗效果。
Objective To investigate the changes and application value of PtiO2, PtiCO2 and pHti in hepatic tissue during hemorrhagic shock and resuscitation. Methods Rabbits (n = 8) were anesthetized and bleed to mean arterial pressure of 40 mmHg (1 mmHg = 0.133 kPa). After 60 minutes of resuscitation, the animals were maintained for 30 min. PtiO2, PtiCO2, bicarbonate concentration ([HCO-3] ti) and pHti were monitored. Results PtiO2 decreased gradually to 0mmHg after shock; PtiCO2 increased slowly initially and then increased rapidly and then slowly increased to (41.6 ± 7.2) mmHg (P <0.01); [HCO-3] ti (2 8.7 ± 4.3) mmol / L (P <0.01), then gradually decreased to (26.3 ± 3.7) mmol / L (P <0.01), pHti To (7.32 ± 0.0 7) (P <0.01). PtiO2 increased rapidly and stabilized at (13.0 ± 2.0) mmHg after resuscitation, PtiCO2 gradually decreased to (38.7 ± 5.9) mmHg (P <0.01) and [HCO-3] ± 4.0 mmol / L (P <0.01), pHti increased to 7.40 ± 0.08 (P <0.01). Conclusion The changes of PtiO2, PtiCO2 and pHti in hemorrhagic shock have certain changes. The monitoring of these indexes is helpful to judge the development, prognosis and therapeutic effect of shock.