高原创伤失血性休克氧疗的实验研究

An experimental study on oxygen therapy applied in traumatic hemorrhagic shock model rabbits in plateau

[目的 ]探讨高原创伤失血性休克氧疗效果 ,为临床用氧提供理论依据。 [方法 ]模拟高原环境 ,制作失血性休克兔模型 ,给予不同浓度氧疗加补液 (Ⅰ、Ⅱ、Ⅲ组 )、氧疗 (Ⅳ组 )和单纯补液组(V组 ) ,休克 1h后进行治疗 ,观察平均动脉压 (MAP)、中心静脉压 (CVP)、血气分析、存活时间 ;再设计理想浓度氧疗加补液 (T组 )和单纯补液对照 (C组 ) ,观察心功能指标。 [结果 ]Ⅰ组、Ⅱ组MAP回升与Ⅳ组有差异 (P <0 .0 5 ,P <0 .0 1) ;Ⅰ组CVP回升与Ⅳ组、Ⅴ组比较有差异 (P <0 .0 1) ;治疗 1hⅣ组HCO3 -下降与Ⅰ组比较 ,P <0 .0 5 ;I组成活时间最长 ;治疗后T组、C组左室收缩压 (LVSP)、左室舒张末压(LVEDP)、左室压力上升及下降的最大速率 (±dp/dtmax)的提高与休克 1h比较均有差异 (P <0 .0 1) ;C组mPAP升高较T组明显 (P <0 .0 5 )。 [结论 ]氧疗是高原失血性休克扩容救治条件下必不可少的护理措施 ,在安全范围内选择高浓度持续给氧 ,有利于改善心功能和有效循环血量 ,减轻酸中毒 ,延长存活时间。

Objective:to probe into the effect of oxygen therapy applied in traumatic hemorrhagic shock model rabbits in plateau, to provide a theoretical basis for clinical applying of oxygen inhalation.Methods:to simulate the circumstances of plateau, hemorrhagic shock of rabbit models were made. And they were divided into group Ⅰ,Ⅱ, Ⅲ according to different concentrations of oxygen inhalation combined with fluids infusion therapy. Rabbits of group Ⅳ were just given oxygen therapy. While group V rabbits simply got fluids infusion therapy. Treatments of all groups rabbits were started 1 h after the shock, and indexes including MAP, CVP, blood gas analysis, and survival time of rabbits were observed. Meanwhile, an ideal oxygen inhalation concentration was designed for group T rabbits besides fluids infusion. And group C rabbits were just given fluid infusion as control. Cardiac functional indexes of group T and group C rabbits were observed. Results: in terms of MAP going-up, there were statistical differences both between group I and group Ⅳ and between group Ⅱ and group Ⅳ (P<0.005;P<0.01). There were significant difference between group Ⅰ and group Ⅳ, group Ⅰ and group Ⅴ in terms of CVP rising (P<0.01).The concentration of HCO 3 in group Ⅳ rabbits was lower than that in group Ⅰ 1 h after the treatment (P<0.05).In terms of survival time, rabbits of group Ⅰ had the longest.Compared with 1 h after the shock,the elevation of LVSP, LVEDP, and ±dp/dtmax of group T and group C rabbits were significantly higher (P<0.01). In terms of mPAP elevation, there was significant difference between group C and group T rabbits (P<0.05).Conclusion:oxygen therapy is an indispensable nursing measure for those with hemorrhagic shock in plateau. Continuous oxygen inhalation at a relatively high concentration within safe range is benefit to the improvement of heart function and the maintenance of effective circulating blood volume. It could also to abate acidosis and prolong the survival time of shock rabbits.