摘要
目的研究连续血液滤过(CRRT)复温过程中,采用全身肝素抗凝或局部枸橼酸抗凝对腹部开放伤合并海水浸泡致意外低体温症犬救治效果的影响。方法选取比格犬19只,制备腹部开放伤合并海水浸泡致低体温症犬模型,按复温方式随机分为三组:CRRT复温全身肝素抗凝组(A组,n=7);CRRT复温局部枸橼酸抗凝组(B组,n=7),温水浴复温组(C组,n=5)。分别于正常体温,降温至34℃,复温至30℃、34℃和38℃时检测血常规、血生化、凝血功能、动脉血气和血流动力学指标。结果三组各时间点的纤维蛋白原(Fib)、血清钾(K+)、总胆红素(TBil)及平均动脉压(MAP)差异无统计学意义(P>0.05);复温至34℃和38℃时,C组的血尿素氮(BUN)较A、B组明显升高,差异有统计学意义(P<0.05)。结论 CRRT复温中,采用全身肝素抗凝或局部枸橼酸抗凝,对腹部开放伤合并海水浸泡致意外低体温症犬Fib、K^+、TBil、BUN、MAP的影响无差别。
Objective To investigate the effect of systemic Heparin anticoagulation or local Citrate anticoagulation on the treatment of sudden hypothermia in beagles with open abdominal trauma and seawater immersion during continuous renal replacement therapy rewarming（CRRT）.Methods Nineteen beagles were enrolled in this study.The animal model of open abdominal trauma coupled with hypothermia induced by seawater immersion was established. Dogs were randomly divided into three groups according to rewarming ways：systemic Heparin anticoagulation group（group A,n=7）,regional Citrate anticoagulation group（group B,n=7）,warm water bath rewarming group（group C,n=5）.The blood routine,blood chemistry,coagulation function,blood gas and hemodynamics indexes were detected at normal temperature,hypothermia to 34℃,rewarming to 30℃,34℃,38℃.Results There was no significant difference in Fib,K＋,TBil and MAP among the three groups at each time point（P0.05）.When rewarming to 34℃ and 38℃,BUN in group C was significantly higher than that in group A and B（P〈0.05）.Conclusion During the progress of CRRT rewarming,there are no difference between Heparin anticoagulantion or Citrate anticoagulation on Fib,K＋,BUN,TBil and MAP for accidental hypothermia dogs with open abdominal trauma and hypothermia induced by seawater immersion.
出处
《中国当代医药》
2017年第24期4-6,10,共4页
China Modern Medicine
基金
全军医学科技青年培育项目(14QNP059)
关键词
连续血液滤过复温
意外低体温症
全身肝素抗凝
局部枸橼酸抗凝
海水浸泡
Continuous renal replacement therapy rewarming
Accidental hypothermia
Systemic Heparin anticoagulation
Regional Citrate anticoagulation
Seawater immersion
