出血性休克时肝脏组织氧分压、二氧化碳分压和酸碱度的变化

Changes of liver PtiO_2, PtiCO_2 and pHti following hemorrhagic shock in rabbits

目的 探讨出血性休克及复苏过程中肝脏局部组织肝脏组织氧分压 (PtiO2 )、二氧化碳分压 (PtiCO2 )和酸碱度 (pHti)的变化规律及其应用价值。 方法 家兔 (兔数 =8)麻醉并放血至平均动脉压 =40mmHg(1mmHg =0 .133kPa) ,6 0min后复苏 ,维持 30min。监测PtiO2 、PtiCO2 、碳酸氢根浓度 ([HCO-3 ]ti)及pHti。 结果 休克后 ,PtiO2 逐渐下降至 0mmHg ;PtiCO2 最初缓慢升高 ,继而急剧升高 ,后又缓慢升高至 (4 1.6± 7.2 )mmHg (P <0 .0 1) ;[HCO-3 ]ti在 30min内逐渐升高至 (2 8.7± 4.3)mmol/L(P <0 .0 1) ;以后逐渐下降至 (2 6 .3± 3.7)mmol/L(P <0 .0 1) ;pHti降至(7.32± 0 .0 7) (P <0 .0 1)。复苏后PtiO2 迅速上升并稳定在 (13.0± 2 .0 )mmHg,PtiCO2 逐渐下降至(38.7± 5 .9)mmHg(P <0 .0 1) ,[HCO-3 ]ti逐渐上升至 (2 7.7± 4.0 )mmol/L (P <0 .0 1) ,pHti逐渐升高至 7.40± 0 .0 8(P <0 .0 1)。 结论 出血性休克时PtiO2 、PtiCO2 和pHti有一定的变化规律 ,对这些指标的监测有利于判断休克的发展、预后及治疗效果。

Objective To study the changes of liver PtiO_2,PtiCO _2 and pHti following hemorrhagic shock. Methods The rabbits were anesthetized and bled to a MAP of 4 0 mm Hg, and then resuscitated after 60 minutes. Liver PtiO_2, PtiCO_2 and pHt i were measured during hemorrhagic shock and the following resuscitation. Results During hemorrhagic shock, PtiO_2 decreased to ze ro gradually; PtiCO_2 increased slowly at first then fast, and slowly again at last to (41.6±7.2) mm Hg (P<0.01); ti increase d to (28.7±4.3) mmol/L (P<0.01) in 30 minutes, then decreased to ( 26.3±3.7) mmol/L (P<0.01); pHti decreased to 7.32±0.07 (P<0.01). After resuscitation, significant increases of PtiO_2 to ( 13.0±2.0) mmHg, ti to (27.7±4.0) mmol/L (P < 0.01), and pHti to 7.40±0.08 (P<0.01) as well as a reducti on of PtiCO_2 to (38.7±5.9) mmHg (P<0.01) were observed. Conclusions Changes of liver PtiO_2,PtiCO_2,ti and pHti may be useful in evaluating the prognosis and treatment effect of hemorrhagic shock.