本文選題：心臟損傷 + 火器��； 參考：《第四軍醫(yī)大學學報》2000年05期

【摘要】：目的　探討急診體外循環(huán) ( ECC)對于心臟火器貫穿傷的支持治療 .方法　雜種犬 2 1只 ,隨機分為對照組、ECC組和 ECC+手術(shù)治療組 .麻醉后用小口徑步槍射擊犬心前區(qū) ,對照組僅行傷口封閉 ,輸液及胸腔閉式引流 .其余兩組于傷后 5～ 7min內(nèi)開始急診 ECC. ECC組持續(xù) ECC 3 h;ECC+手術(shù)治療組于 ECC支持 0 .5 h后行受傷肺葉切除、心臟修補術(shù) ,術(shù)后停 ECC,觀察 3 h.實驗結(jié)束后處死動物取標本 .測量血流動力學指標 ,行血氣分析 .檢測血漿 AL T,BUN,Cr,CK含量 .結(jié)果　各組動物心臟傷均以右室貫穿傷為主 ,傷后 2 min時胸引量為 ( 388± 6 5 ) m L .右室貫穿傷的動物平均動脈壓均在 1min內(nèi)降至 4k Pa以下 .應(yīng)用體外循環(huán)支持可以維持動脈壓為8～ 12 k Pa,循環(huán)后 1h,3 h血液中游離 Hb含量分別是 0 .2 9g.L- 1 和 0 .7g.L- 1 .ECC+手術(shù)治療組動物脫離體外后 1,3h心率、平均動脈壓和中心靜脈壓均與術(shù)前無顯著性差異 .結(jié)論　急診體外循環(huán)可以維持心臟火器貫穿傷動物在傷后 3 h的各項生命指標 ,并能保護各重要臟器功能 .及時地進行手術(shù)修補治療可以明顯提高心臟貫穿傷后的救治效果
[Abstract]:Objective To explore the support and treatment of cardiopulmonary bypass ( ECC ) in patients with cardiac burn . Methods Twenty - one hybrid dogs were randomly divided into control group , ECC group and ECC + surgical treatment group . After anesthesia , a small caliber rifle was used to shoot the anterior chamber of the dog . The control group only had wound closure , infusion and closed thoracic drainage . Emergency ECC was started in the remaining two groups from 5 to 7 minutes after injury . ECC group continued ECC for 3 h ; ECC + surgical treatment group was treated with ECC for 0.5 h , injured pulmonary lobe was removed , heart repair was performed , ECC was stopped after operation , and 3 hours were observed . The animals were sacrificed after the experiment was completed . The hemodynamic parameters were measured and blood gas analysis was performed . The contents of plasma AL T , BUN , Cr and CK were measured . Results The cardiac injury of each group was mainly in the right ventricle , and the chest lead was ( 388 鹵 65 ) m L at 2 min after injury . The mean arterial pressure in the right ventricle was reduced to less than 4 K Pa within 1 min . The contents of free Hb in blood were 0.9g 路 L - 1 and 0.7 g 路 L - 1 , respectively . The rate of heart rate , mean arterial pressure and central venous pressure were not significantly different before operation . Conclusion Emergency cardiopulmonary bypass can maintain the life index of the injured animal after wounding three hours after injury , and can protect the function of each important organ . Timely repair of surgical repair can significantly improve the treatment effect after penetrating injury of the heart
【作者單位】： 第四軍醫(yī)大學西京醫(yī)院心血管外科中心!陜西西安710033 第四軍醫(yī)大學西京醫(yī)院心血管外科中心!陜西西安710033 第四軍醫(yī)大學西京醫(yī)院心血管外科中心!陜西西安710033 第四軍醫(yī)大學西京醫(yī)院心血管外科中心!陜西西安710033 第四軍醫(yī)大學西京醫(yī)院心血管外科中心!陜西西安710033 ，

本文編號：1973927