本文選題：利多卡因 + 靜脈注射�。� 參考：《山西醫(yī)科大學(xué)》2004年碩士論文

【摘要】：目的 (1) 建立犬的利多卡因靜脈注射致死的動(dòng)物模型，，驗(yàn)證員克明研究組建立的利多卡因蛛網(wǎng)膜下腔麻醉致死動(dòng)物模型； 觀察和比較利多卡因靜脈注射和蛛網(wǎng)膜下腔麻醉致死過程的生命體征和死后各組織臟器的病理變化； （2）建立組織臟器和體液中利多卡因的氣相色譜和氣相色譜-質(zhì)譜聯(lián)用分析檢測方法； （3）比較利多卡因在靜脈注射和蛛網(wǎng)膜下腔麻醉致死犬體內(nèi)的分布，為利多卡因硬膜外麻醉意外死亡和中毒案件的法醫(yī)學(xué)鑒定提供科學(xué)依據(jù)。 方法 （1） 動(dòng)物模型 ①利多卡因股靜脈注射致死模型：犬9只，隨機(jī)分為實(shí)驗(yàn)組（6只）和對(duì)照組（3只）兩組，實(shí)驗(yàn)組犬5分鐘內(nèi)經(jīng)股靜脈勻速注入利多卡因5×15mg/kg，對(duì)照組犬注入等體積生理鹽水。②利多卡因蛛網(wǎng)膜下腔麻醉致死模型：犬9只，隨機(jī)分為實(shí)驗(yàn)組（6只）和對(duì)照組（3只）兩組，實(shí)驗(yàn)組犬5分鐘內(nèi)蛛網(wǎng)膜下腔勻速注入利多卡因5×15mg/kg，對(duì)照組犬注入等體積生理鹽水； （2） 生命體征記錄方法 BL-生物機(jī)能實(shí)驗(yàn)系統(tǒng)全程記錄從開始給藥到動(dòng)物死亡的心電、血壓和呼吸等主要生命體征的變化； （3） 樣品采集與處理 心電、血壓和呼吸全部消失時(shí)，迅速解剖動(dòng)物， WP=5 取大腦、側(cè)腦室腦脊液、背側(cè)腦脊液、不同脊髓節(jié)段（頸髓、胸髓、腰髓、骶髓），心、肺、肝、脾、腎、膽汁、尿、心血、周圍血、注射部位肌肉和注射部位20cm以外肌肉等組織臟器和體液，即刻檢測實(shí)驗(yàn)組犬各臟器和體液中利多卡因含量，對(duì)照組犬各臟器和體液用作空白檢材； （4） 病理觀察 取大腦、小腦、脊髓、心、肺、肝、脾、腎，用4%甲醛固定，石蠟包埋，切片，HE染色，光鏡觀察； （5）檢測利多卡因方法 樣品經(jīng)酸、堿化處理后，乙醚萃取，氣相色譜和氣相色譜-質(zhì)譜聯(lián)用檢測，根據(jù)利多卡因的特征離子峰、保留時(shí)間定性與內(nèi)標(biāo)法、工作曲線法定量。 結(jié)果 ( 1 ) 癥狀 靜脈注射實(shí)驗(yàn)組動(dòng)物開始給藥后1~2min出現(xiàn)瞳孔縮小、呼吸困難、口吐粘稠狀白色泡沫、失聲、肌肉震顫、角弓反張、大小便失禁、對(duì)外界刺激極度敏感。蛛網(wǎng)膜下腔麻醉實(shí)驗(yàn)組動(dòng)物在阻滯過程中四肢感覺缺失、強(qiáng)直；開始注藥后1~2min開始出現(xiàn)肌肉震顫、角弓反張、大小便失禁。靜脈注射和蛛網(wǎng)膜下腔麻醉對(duì)照組均未出現(xiàn)以上癥狀，未出現(xiàn)死亡。 （2）生命體征 靜脈注射實(shí)驗(yàn)組犬的心電、血壓和呼吸消失的平均時(shí)間分別為8±2.8 min、6.5±0.7 min、6.5±0.7min。蛛網(wǎng)膜下腔麻醉實(shí)驗(yàn)組犬的心電、血壓和呼吸消失的平均時(shí)間分別為14.3±5.5 min、12.3±5.1 min、17±10.8min。 （3）病理變化 靜脈注射實(shí)驗(yàn)組和蛛網(wǎng)膜下腔麻醉實(shí)驗(yàn)組犬的各組織臟器呈現(xiàn)明顯的非特異的急死的征象。 （4）利多卡因在犬體內(nèi)的分布 靜脈注射實(shí)驗(yàn)組犬體內(nèi)利多卡因的平均含量從高到低依次為：腎（1005.4±515.4μg/g）、心（398.3±377.9μg/g）、肺 WP=6 （320±270.5μg/g）、脾（197.6±113μg/g）、大腦（152.2±128.1μg/g）、肝（54.6±35.2μg/g）、周圍血（50.3±52.9μg/ml）、膽汁（49.3±48.2μg/ml）、心血（48.3±37μg/ml）、頸段脊髓（30±28μg/g）、胸段脊髓（29.3±28.3μg/g）、注射部位肌肉（24.6±9.6μg/g）、腰段脊髓（22.6±19.7μg/g）、注射部位20cm以外的肌肉（21±9.8μg/g）、側(cè)腦室腦脊液（12±14.14μg/ml）、尿（10μg/ml）、背側(cè)腦脊液（8.77μg/ml）、骶段脊髓（8.25±0.29μg/g ）；腎、心、肺、脾、大腦、肝、周圍血、膽汁、心血、頸段脊髓、胸段脊髓、注射部位肌肉、腰段脊髓、注射部位20cm以外的肌肉、側(cè)腦室腦脊液、尿、背側(cè)腦脊液、骶段脊髓與周圍血中利多卡因含量之比分別為： 24.3±26.1、11.7±11.7、6.4±5.7、8.5±6.5、3.5±0.8、1.5±0.8、1.9±1.5、1.0±0.8、1.1±0.9、1±0.7、0.7±0.6、1.6±2.1、0.2±0.01、0.3±0.05、1±0.2、0.5±0.5。蛛網(wǎng)膜下腔麻醉實(shí)驗(yàn)組犬體內(nèi)利多卡因的平均含量從高到低依次為：背側(cè)腦脊液（1650.4±859.6μg/ml）、骶段脊髓（1216.6±1189.2μg/g）、胸段脊髓（1197.6±1019.4μg/g）、側(cè)腦室腦脊液（1144.5±1656.8μg/ml）、腰段脊髓（1071.8±871.6μg/ g）、頸段脊髓（954.4±406.3μg/ g）、肺（220.3±233.1μg/ g）、腎（177±192.2μg/ g）、注射部位肌肉（153.6±150.9μg/ g）、心（109.6±88μg/ g）、大腦（91.8±77μg/ g）、脾（72.2±64.7μg/ g）、心血（37.1±27μg/ml）、肝（31.5±35.8μg/ g）、周圍血（28±22μg/ml）、膽汁（13±9.4μg/ml）、注射部位20cm以外的肌肉（13±7.7μg/ g）、尿（11±5.6μg/ml）；背側(cè)腦脊液、骶段脊髓、胸段脊髓、側(cè)腦室腦脊液、腰段脊髓、頸段脊髓、肺、腎、注射部位肌肉、心、大腦、脾、心血、尿、膽汁、肝、注射部位20cm以外的肌肉與周圍血中利多卡因含量之比分別為: 67±38.3、80.5±140.5、82.1±129.7、100.8±181.9、69.1±110.2、52.5±55.5、17.4±33.3、8.1±11、9.8±15.4、4.9±4.6、3.7±2、3.4±4.3、1.43±1、0.6±0.4、1.5±1.5、0.9±1.4。 WP=7 小 結(jié) 1　本研究建立了利多卡因靜脈注射致死的動(dòng)物模型，驗(yàn)證了員克明研究組建立的利多卡因蛛網(wǎng)膜下腔麻醉致死的動(dòng)物模型。利多卡因
[Abstract]:objective
(1) to establish an animal model of lidocaine intravenous lethal injection in canine, to verify the lethal animal model of lidocaine subarachnoid anaesthesia established by the Kmin research group, and to observe and compare the vital signs of lidocaine intravenous injection and subarachnoid anesthesia and the pathological changes of organs after death.
(2) establish a method for the determination of lidocaine in tissue viscera and body fluid by gas chromatography and gas chromatography-mass spectrometry.
(3) compare the distribution of lidocaine in intravenous and subarachnoid anaesthesia in dogs, and provide a scientific basis for forensic identification of cases of accidental death and poisoning of lidocaine epidural anesthesia.
Method
(1) animal model (1) lethal model of lidocaine femoral vein injection: 9 dogs were randomly divided into experimental group (6) and control group (3 rats). The experimental group was injected with lidocaine 5 * 15mg/kg through femoral vein in 5 minutes, and the control group was injected with equal volume of saline. (2) the death model of lidocara subarachnoid anesthesia: 9 dogs randomly. The experimental group was divided into the experimental group (6) and the control group (3 rats). The experimental group was injected with lidocaine 5 x 15mg/kg in the subarachnoid space in 5 minutes, and the control group was injected with equal volume of normal saline.
(2) the life sign recording method BL- biological function experiment system records the changes of major vital signs, such as the electrocardiogram (ECG), blood pressure and respiration, from the beginning to the death of the animal.
(3) when samples are collected and processed, ECG and blood pressure and respiration disappear, animals are dissected quickly.
WP=5
Cerebrum, lateral ventricle cerebrospinal fluid, dorsal cerebrospinal fluid, different spinal segment (cervical spinal cord, thoracic pulp, lumbar pulp, sacral pulp), heart, lung, liver, spleen, kidney, bile, urine, blood, peripheral blood, intramuscular injection site and 20cm muscle and body fluid outside the injection site, the content of lidocaine in the organs and body fluid of the experimental group and the control group of the dogs were immediately detected. The apparatus and body fluids are used as blank inspection materials.
(4) the brain, cerebellum, spinal cord, heart, lung, liver, spleen and kidney were fixed by 4% formaldehyde, paraffin embedded, sectioning, HE staining and light microscopy.
(5) detection of lidocaine method samples by acid, alkali treatment, ether extraction, gas chromatography and gas chromatography-mass spectrometry combined detection, according to the characteristic ion peak of lidocaine, retention time qualitative and internal standard method, the work curve method quantitative.
Result
(1) in the experimental group, the pupil of 1~2min in the experimental group was reduced, the respiratory difficulty, the puke and the sticky white foam, the sound loss, the muscle tremor, the angle arch, the incontinence, and the extreme sensitivity to the external stimuli. The animals in the subarachnoid anesthesia experiment group were feeling missing and ankylosis during the block of the block, and 1~2 after the drug injection. Min began to develop muscle tremor, armature reversal, fecal incontinence. Intravenous injection and subarachnoid anesthesia control group did not appear above symptoms, no deaths.
(2) the average time of dogs' ECG, blood pressure and respiration in the experimental group was 8 + 2.8 min, 6.5 + 0.7 min and 6.5 + 0.7min. subarachnoid anaesthesia in the experimental group. The average time of blood pressure and respiration disappeared was 14.3 + 5.5 min, 12.3 + 5.1 min, and 17 + 10.8min., respectively.
(3) pathological changes showed that the visceral organs of the experimental group and the subarachnoid anesthesia group showed obvious nonspecific signs of sudden death.
(4) the distribution of lidocaine in the canine experimental group, the average content of lidocaine in the dog was from high to low in the following order: kidney (1005.4 + 515.4 g/g), heart (398.3 + 377.9 mu g/g), lung
WP=6
(320 + 270.5 mu g/g), the spleen (197.6 + 113 mu g/g), the brain (152.2 + 128.1 u g/g), the liver (54.6 +. 35.2 u g/g), the peripheral blood (50.3 +. 52.9 mu), the bile (49.3 + 48.2 mu), the heart blood (48.3 + 152.2 g/ml), the cervical spinal cord (152.2), the thoracic spinal cord (+ + g/g), the lumbar spinal cord (+ = g/g), the injection site 20cm Muscle (21 + 9.8 g/g), lateral ventricle cerebrospinal fluid (12 + 14.14 mu g/ml), urine (10 mu g/ml), dorsal cerebrospinal fluid (8.77 g/ml), sacral spinal cord (8.25 + 0.29 u g/g), kidney, heart, lung, spleen, brain, liver, peripheral blood, bile, heart blood, cervical spinal cord, thoracic spinal cord, injection site muscle, lumbar spinal cord, muscle outside the injection site 20cm, lateral ventricle brain ridge The ratio of the content of lidocaine in liquid, urine, dorsal cerebrospinal fluid, sacral spinal cord and peripheral blood were 24.3 + 26.1,11.7 + 11.7,6.4 + 5.7,8.5 + 6.5,3.5 + 0.8,1.9 + 0.8,1.9 + 0.8,1.1 + 0.8,1.1 + 0.9,1 + 0.7,0.7 + 0.7,0.7 + + 0.7,0.7 +. The volume from high to low was: dorsal cerebrospinal fluid (1650.4 + 859.6 g/ml), sacral spinal cord (1216.6 + 1189.2, g/g), thoracic spinal cord (1197.6 + 1019.4 u g/g), lateral ventricle cerebrospinal fluid (1144.5 + 1656.8 u g/ml), lumbar spinal cord (1071.8 + 871.6 mu g/ g), cervical spinal cord (954.4 + 406.3 g/ g), lung (220.3 + 1197.6 g), kidney (g/ + g/ g), injection site Muscles (153.6 + 150.9 g/ g), the heart (109.6 + 88 g/ g), the brain (91.8 + 77 mu g), spleen (72.2 + 64.7 u g/ g), heart blood (37.1 + 27 u g/ml), liver (31.5 + 35.8 g/ g), peripheral blood (28 + trillion g/ml), bile (+ +), dorsal cerebrospinal fluid, sacral spinal cord, thoracic spinal cord, side The ratio of cerebral ventricle cerebrospinal fluid, lumbar spinal cord, cervical spinal cord, lung, kidney, injection site muscle, heart, brain, spleen, heart blood, urine, bile, liver, and injection site 20cm is 67 + 38.3,80.5 + 140.5,82.1 + 129.7100.8 + 181.9,69.1 + 110.2,52.5 + 110.2,52.5 + 33.3,8.1 + 110.2,52.5 + 15.4,4.9 + 4.6,3.7 + 2,3.4 + 4.3,1.43 + 1,0.6 + 0.4,1.5 + 1.5,0.9 + 1.4.
WP=7
Summary
1 this study established the animal model of lidocaine intravenous lethal injection, and verified the animal model of lidocaine subarachnoid anesthesia established by the member of the member kming research group. Lidocaine
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2004
【分類號(hào)】：D919

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前2條

1 張偉;利多卡因在硬膜外麻醉犬體內(nèi)動(dòng)態(tài)分布的研究[D];山西醫(yī)科大學(xué);2006年

2 張高勤;布比卡因在硬膜外麻醉意外致死犬體內(nèi)的死后再分布研究[D];山西醫(yī)科大學(xué);2007年

本文編號(hào)：1997120