摘要
目的观察海水中火器伤早期血电解质、蛋白、血糖和晶体渗透压的变化,为早期救治方案的拟定提供实验依据。方法将17只普通级比格犬分为海水中致伤组(n=14)和地面致伤组(n=3)。海水组于海水中枪伤后救出,(33.75±25.29)m in经中心静脉测压管采血测试电解质、蛋白、血糖和晶体渗透压,分析其致伤前后的变化。结果海水中火器伤伤后与实验前相比Na+、血糖和晶体渗透压明显升高(P<0.05或P<0.01),总蛋白和白蛋白下降(P<0.05或P<0.01),K+、C l-、Ca2+、球蛋白和白球比值的改变虽无统计学意义(P>0.05),但K+有上升趋势,C l-、Ca2+、球蛋白和白球比值均有下降趋势;火器伤伤后海水组与地面组相比Na+、血糖和晶体渗透压明显增高(P<0.01,P<0.05),K+、C l-、Ca2+、总蛋白、白蛋白、球蛋白和白球比值的改变虽无统计学意义(P>0.05),但K+、C l-比地面组高,而Ca2+、总蛋白、白蛋白、球蛋白和白球比值比地面组低。结论海水中火器伤伤后早期即出现明显的水与电解质紊乱,表现为高钠血症、高钾血症、低氯血症、高渗血症及创伤后“高血糖症”和低蛋白血症,临床救治时应尽早纠正这些紊乱。
Objective To investigate the changes of serum osmotic pressure and electrolyte balance in the early stages of gunshot wound of dogs in seawater for exploring early treatment protocol. Method Fourteen conventional Beagles models undergoing gunshot wound in seawater were used along with another 3 dogs receiving the wound on land to serve as control. After the dogs were res- cued from the seawater, the origin of blood coming from central venous pressure tube was measured （33.75±25.29） min before and after injured for indexes such as Na^＋ , K^＋ , Cl^-, Ca^2＋ , total protein（ TP）, albumin（ ALB）, globulin（ GLB）, albumin/globulin（ A/ G）, blood sugar（BS） and osmolality （OSM） in the early stages of wound, followed by statistical analysis of the results. Results There was a increase in blood Na^＋ （P 〈0.05） and BS, OSM （P 〈 0.01） and blood K^＋ respectively, a decrease in blood TP（ P 〈 0. 01 ） and blood ALB （ P 〈 0.05 ） and blood Cl^- , Ca^2 ＋ , GLB, A/G respectively, and no distinct alteration in blood K^＋ , Cl^ - , Ca^2＋ , GLB, A/G （P〉0.05）. Compared with control, the experimental group in seawater was observed to reveal significant differences in blood Na^＋ , BS （P〈0.01） and OSM（P〈0.05） , and no significance in blood K^＋ , Cl^- , Ca^2＋ , ALB, GLB and A/G（P 〉0.05） , but it was noted that K^＋ and Cl^- contents tended to increase while the level of Ca^2＋ , TP, ALB, GLB and A/G dropped. Conclusions One reason of the high mortality was the early converse changes of turbulence in serum osmotic pressure and electrolyte balance after gunshot wound in seawater. Gunshot injuries in the limbs of dogs exposed to seawater that lead to hyperosmotic dehydration, hypernatremia, hyperkalemia, hypochloremia, hyperglycemia, hypopi＇oteinemia. The early proper treatment can conduce to survival rate of dogs with gunshot wound in seawater according to monitoring serum osmotic pressure and electrolyte balance in golden hour. So should these messes be rectified as early as possible when clinic save to cure.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第9期667-669,共3页
Chinese Journal of Critical Care Medicine
基金
全军"十五"医药卫生科研基金资助课题(No.01MA126)
关键词
火器伤
治疗
海水
电解质
渗透压
比格犬
Gunshot wounds
Treatment
Seawater
Electrolyte
Osmotic pressure
Beagle dogs
