摘要
目的建立静脉复合麻醉下胸大血管转流的动物实验,探讨由急救外科医生组施行大血管转流的紧急手术的可行性。方法由急救外科医生实施静脉复合麻醉,方案为芬太尼+异丙酚+维库溴胺。置犬左侧卧位开胸,拟设降主动脉破裂口,做两层荷包缝合,输液器导管做犬转流导管,外径约3.7mm。结果维持生命在16小时者1条,24小时以上犬1条。解剖发现主动脉断端吻合口无明显渗血,胸腔无积血。此为成功的犬外置血管转流、降主动脉破裂口吻合的急救手术。主要死因分析为模拟创伤失血后,犬无回输血液,造成失血性休克。但在人类,可通过输入同型血源抗休克,解决存活期。结论该动物模型设计合理。由急诊外科医生实施的静脉复合麻醉下大血管转流的动物实验具有临床价值。
Objective： To set up the animal experiment of great intrathoracic vascular shunt in intravenous combined anethesia to investigate the liability of the emergent shunt operation performed by emergency surgeons. Methods： The operations were carried out by the emergency surgeons in intravenous combined anethesia which included fentanyl ＋ propofol ＋ vecuronium bromide.The dogs should be in left lateral position to thoraeotomy.The split site was assigned to thoracic aorta.The pures- string suture was adopted in operative procedure. The tube for transfusion acted as a shunt duck, which outer diameter was 3.7mrn, more or less. Results： One dog kept alive to 16 hours after the operation, and the other over 24 hours.The postmortem dissection disclosed that the anastomotic stoma of breaking end of the aorta in end to end revealed no oozing of blood or hemotocele in thoracic cavity. The emergent operation was successful in split anastomosis of thoracic aorta with the shunt of outlay blood vessel for the dogs. The dogs without returned blood died most likely for hemorrhagic shock after mimic traumatic hemorrhage. The antishock can be used to improve survival time by homotypic blood transfusion for mankind. Conclusion： The animal experiment could be rationally devised. The clinic importance take on great intrathoracic vascular shunt in intravenous combined anethesia of the emergent shunt operation performed by emergency surgeons.
出处
《华西医学》
CAS
2006年第2期317-318,共2页
West China Medical Journal
关键词
动物模型
转流术
胸主动脉
animal model
shunt operation
thoracic aorta
