硝酸甘油诱导低中心静脉压对猪血流动力学及氧代谢的影响

The effect of low central venous pressure induced by nitroglycerin on haemodynamics and metabolism of oxygen in swine

目的 研究低中心静脉压（LCVP）对血流动力学及氧代谢的影响.方法 选择健康猪16头,通过输液控制及小剂量硝酸甘油将CVP调控在0～5 cmH2O,分别在降CVP前（T0,CVP为5～12 cmH2O范围）、CVP调控在0～5 cmH2O水平后15 min（T1）、30 min（T2）三个时段,经漂浮导管测量心排血量（CO）、HR、BP、肺动脉压（PAP）、肺毛细血管楔压（PAWP）、CVP等指标,同时行股动脉、肺动脉及混合静脉血血气分析和动、静脉血乳酸浓度（LacA、LacV）测定.结果 LCVP期平均动脉压（MPAP）、PAWP、体循环血管阻力（SVR）、肺循环血管阻力（PVR）下降,CO、CI增加（P＜0.05）,HR无明显变化;LCVP期全身氧合指标无明显改变.结论 控制性低中心静脉压对猪机体血流动力学无明显不利影响,能维持良好的全身氧供需平衡和氧合状态.

Objective To observe the effect of low central venous pressure（LCVP） on the haemodynamics and metabolism of oxygen in swine. Methods Sixteen hybird swine were selected, After anesthetized,Swan-Ganz catheter was inserted through the right femoral artery; The CVP was kept in 0-5 cm H2O by fluid infusion and nitroglycerin. The haemodynamics and gas aralysis were measured,and metabolism of oxygen was calealated at the time of cvp 5-12 cm H2O,at 15 and 30 rain during LCVP （0-5 cmH2O）. Results During LCVP MPAP, PAWP, SVR and PVR decreased dramatically,while CO and CI increased . During LCVP compared with those before. HR was not changed significantly During LCVP,so did the metabolism of oxygen. Conclusion the technique of manipulated low central venous pressure has no significant effect on haemodynamics,and can maintain good balance between supply and demand of oxygen.