摘要
目的探讨自然海水中火器伤血流动力学的变化特点,为海水中火器伤救治措施的制定提供模拟实际海战的实验依据。方法普通级毕格犬17只随机分为海水中致伤组（n=14）和地面致伤组（n=3）。海水组于海水中枪伤后救出,连续监测早期（53.62±12.19）分钟血流动力学变化及肛温,并采用基础救治;地面组为观察对照。结果海水中枪击伤伤后70分钟内：呼吸（R）和心率（HR）的变化趋势一致,30分钟R[（22.75±2.48）bpm]和HR[（151.00±49.93）bpm]较慢,伤后50分钟时R[（40.67±3.59）bpm]和HR[（204.03±14.08）bpm]较快,二者整体呈跳跃式加快;30分钟时收缩压（SBP）[（138.68±17.93）mmHg]、舒张压（DBP）[（97.60±18.82）mmHg]、平均动脉压（MAP）[（111.33±14.57）mmHg]较低,40-55分钟时变化幅度和波动范围比较大,60-70分钟虽有变化但波动范围小;中心静脉压（CVP）于伤后35-45分钟持续升高并达峰值,之后波动范围不大。海水中枪击伤机体体温下降比地面伤快。结论海水中枪击伤后应尽快补充容量,尽早监测血流动力学、体温,注意保温。
Objective To explore the characteristics of hemodynamic changes and offer simulated experimental foundations for treatment measures of the gunshot wound in natural seawater.Methods Fourteen Beagles models of gunshot wound in seawater were established,and another 3 dogs receiving the wound without seawater immersion were taken as control group.After the dogs injured in seawater,the respiration（R）,rectal temperature（T）,heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean arterial pressure（MAP）,central venous pressure（CVP） of dogs following gunshot wound were measured continually within the（53.62±12.19）minutes.Meanwhile,the treatment measures were adopted.Results Within 70 minutes following injury in seawater,the result showed： the changing trends of R and HR were identical,more slowly within 30~40 minutes and rapidly at 50 minutes in natural seawater;the whole changes of the R and HR leaped increasingly as the duration of time lengthened;the SBP,DBP and MAP were lower at 30 minutes and their fluctuation scopes were larger within 40-55 minutes,but smaller within 60-70 minutes;the CVP increased gradually from 35 to 45 minutes and then peaked（7 mmHg）,and then the fluctuation scope of the CVP was not large;the body temperature declined more rapidly than that in the control group.Conclusion Rapid fluid infusion,monitoring both the hemodynamics and temperature and strengthening heat preservation should be carried out at early stage in Beagle dogs undergoing firearms wound.
出处
《创伤外科杂志》
2010年第1期68-71,共4页
Journal of Traumatic Surgery
基金
全军"十五"医药卫生科研基金资助课题(01MA126)
关键词
火器伤
肢体
血流动力学
远隔效应
体温
firearm wounds
limb
hemodynamics
remote effects
body temperature
