摘要
目的探讨微创介入方舱内早期髂内动脉栓塞对骨盆骨折家犬模型损伤控制性救治的可行性。方法健康家犬20只,随机分为栓塞组和对照组,每组10只。建立骨盆损伤家犬模型,栓塞组根据造影结果选择单侧或双侧髂内动脉栓塞,对照组仅行双侧髂内动脉造影。两组均于造模前、造模后0、2、4、8 h监测家犬心率、呼吸频率、平均动脉压、动脉血气、血常规及肝肾功能。结果两组造模后各时间点呼吸频率、白细胞较造模前增高,栓塞组除造模后0 h平均动脉压外,其他时间点平均动脉压、血红蛋白、氧分压较造模前降低,两组造模后4、8 h血小板高于造模前,差异均有统计学意义(P<0.05)。栓塞组造模后2、4、8 h平均动脉压、心率、呼吸频率、血红蛋白均较造模后0 h降低,造模后4、8 h白细胞、血小板、二氧化碳分压均较造模后0 h升高,差异均有统计学意义(P<0.05,P<0.01),对照组造模后2、4、8 h平均动脉压、血红蛋白、二氧化碳分压较造模后0 h降低,心率、白细胞较造模后0 h升高,造模后4、8 h呼吸频率、血小板较造模后0 h升高,差异均有统计学意义(P<0.05)。栓塞组造模后4、8 h平均动脉压和血红蛋白以及造模后8 h pH值均高于对照组,心率和呼吸均低于对照组,对照组造模后8 h pH值均低于其他时间点,差异均有统计学意义(P<0.05,P<0.01)。两组造模后均出现碱性磷酸酶升高。栓塞组家犬未发生死亡,对照组死亡2只。结论应用野战介入救治方舱在战(现)场对骨盆骨折家犬模型实施介入栓塞可以较长时间稳定生命体征、明显减少出血量并保护肝肾功能,是提高骨盆骨折伤员救治率的有效方法之一。
[Abstract] Objective To explore the feasibility of early internal iliac arterial embolization in damage control treatment of pelvic fracture in dogs. Methods Twenty healthy dogs were randomly divided into embolism group （n = 10） and control group （n = 10）. Pelvic injury models were established. The unilateral or bilateral internal iliac arterial embolization was carried out in embolism group according to angiographic results, while control group only received bilateral internal iliac arteriography. Heart rate, respiratory rate, mean arterial pressure, arterial blood gas, routine blood test and liver and renal functions of dogs in the two groups were monitored before and 0 h, 2 h, 4 hand 8 h after model establishment. Results In the two groups, respiratory rate and leukocyte level were higher at each monitor time after modeling than those before modeling; mean arterial pressure, levels of hemoglobin and oxygen partial pressure were significantly lower at each monitor time after modeling than those before modeling except for mean arterial pressure at 0 h in embolization group; platelets levels at 4 hand 8 h were higher than those before modeling, and the differences were statistically significant （P 〈 0. 05 ）. In embolization group after modeling, mean arterial pressure, heart rate, respiratory rate and hemoglobin level at 2 h, 4 hand 8 h were lower than those at 0 h; levels of leukocytes, platelets and carbon dioxide partial pressure at 4 hand 8 h after modeling were higher than those at 0 h , and the differences were statistically significant （ P 〈 0. 05 ,P 〈 0. 01 ） ; in control group after modeling, mean arterial pressure, levels of hemoglobin and carbon dioxide partial pressure on 2 h, 4 hand 8 h were lower than those at 0 h , levels of heart rate and leukocytes were higher than those of before modeling, respiratory rate and platelets level at 4 hand 8 h were higher than those at 0 h , and the differences were statistically significant （P 〈 0.05）. Levels of mean arterial pressure and hemoglobin at 4 hand 8 h and Ph value at 8 h after modeling in embolization group were significantly higher than those in control group, while heart rate and respiratory rate at 4 hand 8 h were significantly lower than those in control group. Ph value at 8 hafter modeling was significantly lower than those of other monitor times in control group （P 〈 0. 05 ,P 〈 0.01）. The two groups had elevated level of alkaline phosphatase after modeling. No death occurred in embolization group, but 2 deathes were recorded in control group. Conclusion Early internal iliac arterial embolization in damage control treatment of pelvic fracture in dog models can stabilize vital signs and significantly reduce the bleeding volume for a long time, and it is effective in treatment of the pelvic fracture.
出处
《解放军医药杂志》
CAS
2014年第1期5-9,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
全军"十二五"重点课题(BWS12J006)
全军医学科技青年培育项目(13QNP003)
辽宁省自然科学基金(201202241)
关键词
微创介入方舱
骨盆
骨折
栓塞
治疗性
狗
Traveling medical cabin
Pelvis
Fracture
Embolization, therapeutic
Dog
