【摘要】：目的　通過建立小型豬火器多發(fā)傷模型 ,探討多發(fā)傷時(shí)血液動(dòng)力學(xué)變化的特點(diǎn)。方法　采用 5 8mm子彈射擊顱頂骨和雙側(cè)股骨 ,制作火器多發(fā)傷模型。 12只小型豬隨機(jī)分為對(duì)照組(不致傷 )和多發(fā)傷組各 6只。觀察創(chuàng)傷后平均動(dòng)脈壓 (MAP)、平均肺動(dòng)脈壓 (MPAP)、肺動(dòng)脈嵌壓(PCWP)、心輸出量 (CO)、外周血管阻力指數(shù) (SVRI)以及門靜脈血流量和胃粘膜內(nèi) pH值的變化特點(diǎn)。結(jié)果　對(duì)照組血液動(dòng)力學(xué)指標(biāo)無明顯變化 ;多發(fā)傷組傷后MAP一過性升高 ,4 8～ 72h出現(xiàn)“高排低阻”現(xiàn)象 :心輸出量明顯增加 ,平均動(dòng)脈壓和體循環(huán)外周阻力指數(shù)下降 (傷后 72h為 978± 6 5 ) ,MPAP和PCWP升高 ;門靜脈血流量下降傷后 72h為 [(344± 84 )ml·kg-1·min-1];胃粘膜缺血缺氧。結(jié)論　火器多發(fā)傷后在無嚴(yán)重失血情況下也會(huì)發(fā)生全身血流重新分布 ,內(nèi)臟灌流不足。
[Abstract]:Objective to study the characteristics of hemodynamic changes in multiple injuries in miniature pigs by establishing a model of multiple injuries with firearm. Methods 5 8mm bullets were used to shoot cranio-parietal bone and bilateral femur to make multiple injury model of firearm. Twelve miniature pigs were randomly divided into control group (without injury) and multiple injury group (n = 6). The changes of mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), (PCWP), cardiac output (CO), peripheral vascular resistance index (SVRI), portal vein blood flow (PVF) and gastric intramucosal pH (pH) were observed after trauma. Results there was no significant change in hemodynamic indexes in the control group, but the MAP in the multiple injury group was temporarily increased, and the phenomenon of "high output and low resistance" appeared from 48 to 72 hours. The cardiac output was increased obviously. Mean arterial pressure and peripheral resistance index of systemic circulation decreased (72h after injury, 978 鹵65), MPAP and PCWP increased, portal vein blood flow decreased 72 h after injury [(344 鹵84) ml kg-1 min-1], gastric mucosal ischemia and hypoxia). Conclusion the systemic blood flow will be redistributed and the visceral perfusion will be insufficient after multiple firearm injury without severe blood loss.
【作者單位】： 中國人民解放軍第三零四醫(yī)院普外科 中國人民解放軍第三零四醫(yī)院普外科 中國人民解放軍第三零四醫(yī)院普外科 中國人民解放軍第三零四醫(yī)院普外科 海軍總醫(yī)院普外科
【基金】：全軍九五指令性課題資助項(xiàng)目 (NO .96L0 5 3 )
【分類號(hào)】：R82

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