高压氧对犬严重肺冲击伤的治疗研究

Role of hyperbaric oxygen treatment on canine severe lung blast injury

目的 观察高压氧对犬严重肺冲击伤的治疗效果。方法 将 18条成年犬随机分为对照组与高压氧治疗组。用BST 1生物激波管造成犬严重肺冲击伤 ,对照组伤后立即给予吸氧、补液、抗感染等处理 ;高压氧治疗组在以上处理基础上于伤后 5小时给予高压氧治疗。两组均于伤前及伤后 0 .5、4、8、12小时等时相点检测血气与血流动力学指标 ,观察伤后 2 4小时内肺体指数及死亡率。结果 两组动物伤后血气及血流动力学指标均发生严重紊乱 ,HR、sBP、PO2 、SO2 、CI、CO及LCW等指标明显下降 ,而SVR、SVRI显著增高 ,但治疗后高压氧治疗组PO2 略高于对照组 ,而SVR、SVRI略低于对照组。对照组伤后 2 4小时肺体指数为 (1.83± 0 .38) % ,死亡率为 4 0 % ;高压氧治疗组伤后 2 4小时肺体指数为 (1.35± 0 .19) % ,明显低于对照组 (P <0 .0 5 ) ,死亡率仅为 12 .5 %。

Objective To observe the role of hyperbaric oxygen(HBO) in the treatment of canine severe lung blast injury.?Methods 18 mature dogs were divided into control group and HBO treatment group randomly. BST 1 type bio shock tube was used to induce severe lung blast injury. Immediately after injury,the animals in both groups were placed at semi reclining position,and treated with oxygen supplying,fluid replacement and antibiotics. In treatment group,the animals were treated with additional HBO 5h after injury. Hemodynamics and blood gas were detected pre injury and 0.5,2,4,6,8,12h post injury. Index of lung weight/body and mortality rate during 24h were also observed.?Results After injury,hemodynamics and blood gas were significantly disordered in both groups,HR,sBP,PO 2 ,SO 2 ,CI,CO,and LCW decreased markedly while SVR and SVRI in disorder increased significantly. After HBO treatment,PO 2 was slightly higher in HBO group than that found in control group but SVR,and SVRI were slightly lower. The average index of lung/body was (1.83±0.38)% in the control group and ( 1.35±0.19)% in HBO group(P<0.05). The mortality rate in 24h was 40% in the control group and 12.5% in HBO group. ?Conclusion Hyperbaric oxygen plays an important role in the treatment of canine severe lung blast injury.