摘要
目的 利用超声心动图结合有创心功能分析方法对比研究家兔心肌挫伤后心功能的早期变化及其规律。方法 选用健康家兔 30只 ,用BIM Ⅱ型生物撞击机制备家兔中 -重度心肌挫伤模型 ,观察致伤前、致伤后 1,4 ,8及 2 4小时左心收缩及舒张功能与血流动力学变化。结果 家兔中 -重度心肌挫伤后 ,伤后 1～ 4小时HR、SP、DP、MAP明显降低 ,LVSP、+dp/dtmax、IP、Vmax也明显降低 ,在伤后 8～ 2 4小时 ,上述指标基本恢复至伤前水平。LVEDP ,-dp/dtmax、T等在伤后 1小时均明显升高 ,至伤后 8小时未见明显回落。反映右室收缩功能的中心静脉压 (CVP)在伤后呈持续性升高 ,至伤后 2 4小时未见恢复。超声心动图检查发现 ,左室EF在伤后 2 4小时才明显降低 ,SV在伤后 1小时即明显下降 ,4～ 8小时有所恢复 ,至伤后 2 4小时又出现明显降低 ,收缩末期容积和舒张末期容积在伤后有较大的增加 ,但在致伤 8小时后才有显著差异。结论 心肌挫伤后心脏左右心室收缩和舒张功能均有明显损害。左室以舒张功能障碍为主 ,收缩功能恢复较快 ,右室以收缩功能障碍为主。超声心动图在胸部撞击伤后早期心功能损害的检诊中可能具有较大的实用意义。
Objective To study the changes and its rules of left ventricular functions in rabbits with myocardial contusion, through the parallel functional analysis by echocardiography combined with cardiac catheter intervention.?Method Thirty healthy rabbits were selected and were impacted by BIM Ⅱ biomedical impact machine to produce moderate or severe myocardial contusion. The changes of hemodynamics and cardiac systolic and diastolic functions were observed respectively at time phases as before and 1,4,8,24hours after wounding.?Results After myocardial contusion, the HR, SP, DP and MAP of rabbits decreased remarkably at 1 4 hours. The left ventricular end systolic pressure(LVESP), the maximum increasing rate of left intraventricular pressure(+dp/dtmax),isovolumic pressure(IP) and the maximum systolic velocity of left ventricle(Vmax) also decreased markedly. And then these parameters returned to pre wounding level at 8 24 hours. The ventricular end diastolic pressure(LVEDP),the maximum decreasing rate of left intraventricular pressure (-dp/dtmax)?and the decreasing time constant of left intraventricular pressure(T) increased remarkably 1 hour after MC.These parameters were not decreased until 8 hours after MC. The level of CVP, which reflects the systolic function of right ventricle,showed a continual increase until 24 hours after MC. Detection by echocardiography showed that EF of the left ventricle markedly decreased at 24 hours after MC, while SV decreased obviously as early as 1 hour after MC, at 4 8 hours it recovered a little and then again decreased at 24 hours. The ESV and EDV increased after MC, but statistical significance was only seen at 8 hours after MC.?Conclusion It suggested that cardiac functions of the left and right ventricle showed marked injuries after MC. Dysfunction of left ventricle diastolic and right ventricle systolic functions are major disorders,while the systolic functions of left ventricle could recover rapidly. Echocardiography is very important in the detection of early injuries of cardiac functions.
出处
《创伤外科杂志》
2003年第1期42-45,共4页
Journal of Traumatic Surgery
