發(fā)布時(shí)間：2018-05-05 09:59

  本文選題：胸部損傷 + 創(chuàng)傷��； 參考：《中華創(chuàng)傷雜志》2000年11期

【摘要】：目的　探討胸部槍傷瞬時(shí)及早期心血管效應(yīng)及其機(jī)制�！》椒ā� 30只家兔隨機(jī)平均分為A :胸部貫穿傷組 (模型組 )、B :預(yù)扎肋間動(dòng)脈致傷組、C :人工氣胸后致傷組、D :預(yù)扎肋間動(dòng)脈 +人工氣胸后致傷組、E :胸壁切線傷組。分別用 5 .5 6mm小口徑步槍致傷 ,連續(xù)監(jiān)測動(dòng)脈壓、心率、靜脈壓、心電圖、左室內(nèi)壓等�！〗Y(jié)果　A組傷前血壓峰值為 ( 14.80± 1.2 9)kPa ( 1kPa =7.5mmHg) ,槍傷瞬間血壓即刻呈單波峰升高 ,達(dá)傷前的 ( 1.5 8± 0 .0 8)倍 ,而后迅速降低至傷前水平以下 ,10s下降到最低點(diǎn) ,30s開始回升 ,1min后回升至傷前的 ( 0 .80± 0 .0 7)倍 ,并逐漸穩(wěn)定。靜脈壓瞬時(shí)升高后隨即下降 ,左室內(nèi)壓和心率出現(xiàn)瞬時(shí)下降、而后逐漸恢復(fù) ,B組和C組變化幅度較小。D組和E組僅槍擊瞬間有短暫變化�！〗Y(jié)論　胸部槍傷瞬間動(dòng)、靜脈壓升高 ,而左室內(nèi)壓無變化 ,為槍彈沖擊波直接引起。傷后數(shù)秒內(nèi)血壓下降 ,心動(dòng)過緩 ,心肌受抑制和左室內(nèi)壓下降 ,而中心靜脈壓尚正常 ,提示與迷走反射有關(guān)。模型組于傷后 2h血壓再度下降 ,則可能與胸內(nèi)失血和肺損傷有關(guān) ,缺氧也造成了心肌收縮力下降。預(yù)扎肋間動(dòng)脈及臨時(shí)造成人工氣胸防止肺實(shí)質(zhì)損傷 ,可減輕槍傷早期的心血管功能障礙。
[Abstract]:Objective to investigate the transient and early cardiovascular effects of thoracic gunshot injury and its mechanism. Methods Thirty rabbits were randomly divided into two groups: group A: group B: group C: group D: group C: group D: group C: group D: group C: group Arterial pressure, heart rate, venous pressure, electrocardiogram and left ventricular pressure were continuously monitored with 5. 5 6mm small caliber rifle. Results the peak value of blood pressure in group A was (14.80 鹵1.2 9)kPa) (1kPa 7.5mmHg), and the peak of blood pressure was increased immediately after gunshot injury (1.58 鹵0.08) times. However, it decreased rapidly to the lowest level in 10 s below the pre-injury level and began to rise 1 min after 30 s, and then increased to 0. 80 鹵0. 07 times of that before injury, and gradually stabilized. The venous pressure immediately decreased, left ventricular pressure and heart rate decreased, and then gradually recovered to B and C groups. The range of change was smaller. Group D and group E had only a brief change in the instant of shooting. Conclusion the venous pressure of chest gunshot wound was increased, but the left ventricular pressure was not changed, which was directly caused by gunshot shock wave. The decrease of blood pressure, bradycardia, myocardial inhibition and left ventricular pressure decrease within a few seconds after injury, but the central venous pressure is normal, suggesting that it is related to vagal reflex. The decrease of blood pressure at 2 h after injury may be related to intrathoracic blood loss and lung injury, and hypoxia also resulted in a decrease in myocardial contractility. Preligation of intercostal artery and temporary artificial pneumothorax can prevent lung parenchyma injury and reduce cardiovascular dysfunction in the early stage of gunshot injury.
【作者單位】： 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 第四軍醫(yī)大學(xué)附屬西京醫(yī)院胸心外科中心 ，

本文編號(hào)：1847244