摘要
目的 研究鸟苷酸环化酶抑制药亚甲蓝对感染性休克犬肠道灌注和氧合的影响。方法 静脉注入内毒素诱导的 7只感染性休克犬模型 ,输注 0 9%氯化钠复苏后 15分钟内注入亚甲蓝2mg/kg。血流量仪测定基础、休克 1小时后、复苏后和亚甲蓝注入后 30分钟肠系膜上动脉血流量。分析动脉和肠系膜上静脉血气 ,计算肠道氧合。结果 犬感染性休克后 ,肠系膜上动脉 (肠道 )血流减少 6 1 8% (P <0 0 1) ,氧输送 (DO2 )减少 6 2 1% (P <0 0 1) ,氧摄取 (O2 extr)增加 2 3 5 %。复苏至肺动脉嵌压为 (12 1± 1 4 )mmHg后 ,肠道血流增加 5 4 6 % (P <0 0 1) ,DO2 增加 12 8% (P <0 0 1) ,O2 extr增加 2 0 9%。亚甲蓝注入后 ,肠道血流增加 19 4 % (P <0 0 1) ,DO2 则无明显变化 (P >0 0 5 ) ,O2 extr增加 14 8%。结论 感染性休克后肠道血流灌注减少 ,氧耗增加 ;液体复苏仅部分恢复肠道灌注 ;
Objective To study the effects of methylene blue(MB),a soluble guanylate cyclase inhibitor,on intestinal perfusion and oxygenation in dogs with septic shock.Methods A septic shock model was estabilished by infusion Lipopolysaccharide.After resuscitation with normal saline,2mg/kg MB was infusied within 15min in seven dogs.Blood flow of the superior mesenteric artery(SMA) was measured at baseline,shocked for 1h,after volume resusciatin and 30min after MB injection.Blood gas analysis wsa done,and oxygenation was calculated.Results Blood flow of the SMA was significantly decreased by 61 8%( P< 0 01)in dogs with septic shock,oxygen delivery(DO 2) was decreased by 62 1%( P< 0 01) and oxygen extraction(O 2extr) was increased by 23 5%.When pulmonary artery wedge pressure reached to a level of (12 1±1 4)mmHg with fluid resusciation,blood flow of the SMA was significantly increased by 54 6%( P< 0 01),DO 2 increased by 12 8%( P< 0 01),and O 2extr increased by 23 5%.After MB infusion,blood flow of the SMA was increased by 19 4%( P< 0 01).DO 2 remained unchanged( P> 0 05),but O 2extr increased by 14 8%.Conclusion Septic shock in dogs results in a decrease in intestinal perfusion and an increase in oxygen extraction,which can be improved by MB injection.The intestinal perfusion is partly increased by volume therapy. [
出处
《临床麻醉学杂志》
CAS
CSCD
2002年第8期429-431,共3页
Journal of Clinical Anesthesiology
关键词
感染性休克
肠道血流灌注
氧合
亚甲蓝
Septic shock
Intestinal blood perfusion
Oxygenation
Methylene blue
